Healthcare Provider Details

I. General information

NPI: 1932514502
Provider Name (Legal Business Name): JOANNE MARIE DUFFIELD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JODI FIDELMAN

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 08/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 13833
PHILADELPHIA PA
19101-3833
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-7002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9295035
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: