Healthcare Provider Details

I. General information

NPI: 1174449284
Provider Name (Legal Business Name): DIANA RACHELLE ANDERSEN-DAVIS APRN, DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANA RACHELLE FOWLER APRN, DNP, FNP-BC

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1549 GALE LEMERAND DR STE 4592
GAINESVILLE FL
32610-3008
US

IV. Provider business mailing address

PO BOX 103204
GAINESVILLE FL
32610-0238
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0140
  • Fax:
Mailing address:
  • Phone: 352-294-8278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11048771
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: