Healthcare Provider Details

I. General information

NPI: 1740596451
Provider Name (Legal Business Name): ANTOINETTE YVETTE FRUSSINETTY DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2010
Last Update Date: 10/05/2022
Certification Date: 10/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7562 W GULF TO LAKE HWY
CRYSTAL RIVER FL
34429-7840
US

IV. Provider business mailing address

7562 W GULF TO LAKE HWY
CRYSTAL RIVER FL
34429-7840
US

V. Phone/Fax

Practice location:
  • Phone: 352-436-4328
  • Fax:
Mailing address:
  • Phone: 352-436-4328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF336221-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: