Healthcare Provider Details

I. General information

NPI: 1144764598
Provider Name (Legal Business Name): CANDY WHITINGER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2016
Last Update Date: 06/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610
US

IV. Provider business mailing address

DIVISION OF GENERAL SURGERY BOX 100109
GAINESVILLE FL
32610-0109
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0761
  • Fax:
Mailing address:
  • Phone: 352-265-0761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9278357
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: