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General NPI Number Information
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NPI Number | 1033745211
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Entity Type | Individual
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Provider Name | BARRON NICHOLAS RODDEY APRN
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Gender | Male
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Dates
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Enumeration Date | 03/19/2020
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Last Update Date | 03/19/2020
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Provider Practice Location Address
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Address Line | 1181 ANCLOTE RD LOT 35
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-6642
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Country | US
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Telephone | 727-946-1074
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Fax |
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Provider Business Mailing Address
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Address Line | 1181 ANCLOTE RD LOT 35
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-6642
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Country | US
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Telephone | 727-946-1074
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 11006384
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License Number State | FL
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