Healthcare Provider Details

I. General information

NPI: 1417969858
Provider Name (Legal Business Name): NYEMBEZI EDWARDS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

2514 SW 146TH ST
NEWBERRY FL
32669-4604
US

V. Phone/Fax

Practice location:
  • Phone: 352-376-1611
  • Fax: 352-379-2428
Mailing address:
  • Phone: 352-333-9740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP1179862
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: