Healthcare Provider Details

I. General information

NPI: 1124459920
Provider Name (Legal Business Name): CONSTANCE MARIE ALFORD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. CONSTANCE MARIE STICHWEH

II. Dates (important events)

Enumeration Date: 12/03/2013
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD BOX 100296
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

1600 SW ARCHER RD BOX 100298
GAINESVILLE FL
32610-3003
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-9120
  • Fax: 352-273-5941
Mailing address:
  • Phone: 352-273-9120
  • Fax: 352-273-5941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 9191069
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: