Healthcare Provider Details

I. General information

NPI: 1184841454
Provider Name (Legal Business Name): ELOISE KAY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 NW 60TH ST
GAINESVILLE FL
32607-2008
US

IV. Provider business mailing address

131 SW 84TH TER
GAINESVILLE FL
32607-1434
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-5100
  • Fax: 352-332-9607
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP2709472
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: