Healthcare Provider Details

I. General information

NPI: 1043580186
Provider Name (Legal Business Name): CINDY ANN NELLY APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2012
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 SW 8TH DR
GAINESVILLE FL
32601-8415
US

IV. Provider business mailing address

1920 SW 8TH DR
GAINESVILLE FL
32601-8415
US

V. Phone/Fax

Practice location:
  • Phone: 352-219-5338
  • Fax:
Mailing address:
  • Phone: 352-219-5338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN9165405
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: