Healthcare Provider Details
I. General information
NPI: 1508755356
Provider Name (Legal Business Name): JENNIFER NAGLE APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/28/2025
Last Update Date: 06/28/2025
Certification Date: 06/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
918 ROLLING ACRES RD STE 102
LADY LAKE FL
32159-5027
US
IV. Provider business mailing address
3920 SE 17TH ST
OCALA FL
34471-4912
US
V. Phone/Fax
- Phone: 352-751-6582
- Fax:
- Phone: 352-877-1864
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 11040009 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: