Healthcare Provider Details

I. General information

NPI: 1275149916
Provider Name (Legal Business Name): KRISTEN ANNE NUTTER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTEN DAGHER

II. Dates (important events)

Enumeration Date: 09/18/2020
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 COMMERCIAL WAY
SPRING HILL FL
34606-3300
US

IV. Provider business mailing address

249 DARTMOUTH AVE
SPRING HILL FL
34606-5436
US

V. Phone/Fax

Practice location:
  • Phone: 352-688-3379
  • Fax: 352-398-1333
Mailing address:
  • Phone: 352-587-4811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11009048
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: