Healthcare Provider Details

I. General information

NPI: 1477020337
Provider Name (Legal Business Name): LIDIA NENCIU APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2018
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5941 BERRYHILL RD STE E
MILTON FL
32570-4043
US

IV. Provider business mailing address

1940 CATAMARAN DR
NAVARRE FL
32566-2114
US

V. Phone/Fax

Practice location:
  • Phone: 850-396-1322
  • Fax: 850-396-0206
Mailing address:
  • Phone: 850-374-7279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9385839
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9385839
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: