Healthcare Provider Details

I. General information

NPI: 1841377850
Provider Name (Legal Business Name): NANCY MAE FRUIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2634 CAPITAL CIR NE
TALLAHASSEE FL
32308-4106
US

IV. Provider business mailing address

2634 CAPITAL CIR NE
TALLAHASSEE FL
32308-4106
US

V. Phone/Fax

Practice location:
  • Phone: 850-523-3333
  • Fax: 850-523-3411
Mailing address:
  • Phone: 850-523-3333
  • Fax: 850-523-3411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP2756322
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: