Healthcare Provider Details

I. General information

NPI: 1497181986
Provider Name (Legal Business Name): JESSIE M CAUDILL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2553 E SILVER SPRINGS BLVD
OCALA FL
34470-7009
US

IV. Provider business mailing address

2553 E SILVER SPRINGS BLVD
OCALA FL
34470-7009
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-6599
  • Fax: 352-732-4816
Mailing address:
  • Phone: 352-732-6599
  • Fax: 352-732-4816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28168439A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: