Healthcare Provider Details

I. General information

NPI: 1356793624
Provider Name (Legal Business Name): ERICA L STAUDINGER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2016
Last Update Date: 06/17/2020
Certification Date: 06/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11181 HEALTH PARK BLVD STE 1165
NAPLES FL
34110
US

IV. Provider business mailing address

PO BOX 8569
NAPLES FL
34101-8569
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-0320
  • Fax: 239-624-0321
Mailing address:
  • Phone: 239-624-0400
  • Fax: 239-624-0464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9327066
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP9327066
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: