Healthcare Provider Details

I. General information

NPI: 1356486609
Provider Name (Legal Business Name): PATIENCE CORNER NURSE-MIDWIFERY CANTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 SW 4TH AVE
GAINESVILLE FL
32601-6457
US

IV. Provider business mailing address

717 SW 4TH AVE
GAINESVILLE FL
32601-6457
US

V. Phone/Fax

Practice location:
  • Phone: 352-378-2882
  • Fax: 352-377-8250
Mailing address:
  • Phone: 352-378-2882
  • Fax: 352-377-8250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number285
License Number StateFL

VIII. Authorized Official

Name: LOUANN HILLEBRAND
Title or Position: CHIEF ADMINISTRATOR
Credential: A.R.N.P.
Phone: 352-378-2882