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NPI Code Detail

MEDICARE: MS. VERNA LYNN PEDERSEN RUNYAN ARNP

MEDICARE:  MS. VERNA LYNN PEDERSEN RUNYAN  ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerF331179NY
2363LF0000XFamily Nurse Practitioner9221658FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Y06FUOTHERBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740287523
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VERNA LYNN PEDERSEN RUNYAN ARNP
Provider Business Mailing Address
First Line : 14690 SPRING HILL DR STE 101
Second Line :
City : SPRING HILL
State : FL
Zip : 34609-8102
Country : US
Telephone Number : 352-799-0046
Fax Number : 352-606-2857
Provider Business Practice Location Address
First Line : 4270 LAKE IN THE WOODS DR
Second Line :
City : WEEKI WACHEE
State : FL
Zip : 34607-2501
Country : US
Telephone Number : 352-597-7249
Fax Number : 352-597-9523
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 07/21/2022

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Directions to “ MS. VERNA LYNN PEDERSEN RUNYAN ARNP” Practice Location

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