Healthcare Provider Details

I. General information

NPI: 1356339725
Provider Name (Legal Business Name): DEBORAH MAICHLE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7981 GLADIOLUS DRIVE
FORT MYERS FL
33908
US

IV. Provider business mailing address

7981 GLADIOLUS DRIVE ASSOCIATES IN NEPHROLOGY
FORT MYERS FL
33908
US

V. Phone/Fax

Practice location:
  • Phone: 239-939-0999
  • Fax: 239-939-1070
Mailing address:
  • Phone: 239-939-0999
  • Fax: 239-939-1070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLG0000127
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAC000043
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code163WN0300X
TaxonomyNephrology Registered Nurse
License NumberARNP9236889
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: