Healthcare Provider Details

I. General information

NPI: 1972081438
Provider Name (Legal Business Name): NWANNE JUDITH NKWOCHA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2018
Last Update Date: 05/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10494 NORTHCLIFFE BLVD
SPRING HILL FL
34608-3656
US

IV. Provider business mailing address

14690 SPRING HILL DR STE 305
SPRING HILL FL
34609-8102
US

V. Phone/Fax

Practice location:
  • Phone: 352-686-3991
  • Fax: 352-666-0393
Mailing address:
  • Phone: 352-277-5348
  • Fax: 352-606-2857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9329096
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: