Healthcare Provider Details

I. General information

NPI: 1962698233
Provider Name (Legal Business Name): NANCY LINDA ZAHARIS ARNP, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 NORTH BLVD W
DAVENPORT FL
33837-8990
US

IV. Provider business mailing address

PO BOX 667
DAVENPORT FL
33836-0667
US

V. Phone/Fax

Practice location:
  • Phone: 863-421-7600
  • Fax: 863-421-7551
Mailing address:
  • Phone: 863-421-7600
  • Fax: 863-421-7551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP1381842
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberARNP1381842
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: