Healthcare Provider Details

I. General information

NPI: 1437828266
Provider Name (Legal Business Name): ERIN LORRAINE CONNIFF APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 09/13/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6360 PINE RIDGE RD
NAPLES FL
34119-3907
US

IV. Provider business mailing address

4371 VERONICA S SHOEMAKER BLVD
FORT MYERS FL
33916-2216
US

V. Phone/Fax

Practice location:
  • Phone: 239-353-6636
  • Fax: 239-354-1865
Mailing address:
  • Phone: 239-274-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11014675
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: