Healthcare Provider Details

I. General information

NPI: 1720077415
Provider Name (Legal Business Name): DEBRA LUCE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N US HIGHWAY 441 STE 540
LADY LAKE FL
32159-8987
US

IV. Provider business mailing address

PO BOX 102222
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 352-753-9777
  • Fax: 866-446-1888
Mailing address:
  • Phone: 239-274-8200
  • Fax: 239-278-3350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP1552402
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: