Healthcare Provider Details

I. General information

NPI: 1932657871
Provider Name (Legal Business Name): ANISSA HOHNSTREITER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2016
Last Update Date: 04/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 N FLORIDA AVE
LAKELAND FL
33805-3109
US

IV. Provider business mailing address

1600 LAKELAND HILLS BLVD.
LAKELAND FL
33805-3019
US

V. Phone/Fax

Practice location:
  • Phone: 863-904-6200
  • Fax: 863-904-6281
Mailing address:
  • Phone: 863-680-7000
  • Fax: 866-264-8519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number9181641
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number9181641
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN9181641
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: