Healthcare Provider Details

I. General information

NPI: 1942686811
Provider Name (Legal Business Name): CINDY ANN GROW ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2015
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 W JEFFERSON ST APT 318
WATERLOO IA
50701-1331
US

IV. Provider business mailing address

108 N MAGNOLIA AVE STE 324
OCALA FL
34475-6642
US

V. Phone/Fax

Practice location:
  • Phone: 352-267-8897
  • Fax: 844-371-5416
Mailing address:
  • Phone: 352-821-0188
  • Fax: 844-371-5416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9326861
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberARNP9326861
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: