Healthcare Provider Details

I. General information

NPI: 1144707183
Provider Name (Legal Business Name): KEVIN TROUP APRN FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2018
Last Update Date: 01/28/2022
Certification Date: 11/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1234 SE MAGNOLIA EXT UNIT 1
OCALA FL
34471-3770
US

IV. Provider business mailing address

1234 SE MAGNOLIA EXT UNIT 1
OCALA FL
34471-3770
US

V. Phone/Fax

Practice location:
  • Phone: 352-401-1218
  • Fax: 352-401-1017
Mailing address:
  • Phone: 352-401-1218
  • Fax: 352-401-1017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPRN9374283
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN9374283
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9374283
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: