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General NPI Number Information
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NPI Number | 1083831861
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Entity Type | Individual
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Provider Name | ANDREA E WATERHOUSE ARNP
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Gender | Female
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 02/17/2017
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Provider Practice Location Address
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Address Line | 395 W MAIN ST
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City | LAKE BUTLER
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State | FL
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Zip | 32054-1642
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Country | US
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Telephone | 386-496-3154
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Fax | 386-496-1246
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Provider Business Mailing Address
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Address Line | PO BOX 100371
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City | GAINESVILLE
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State | FL
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Zip | 32610-0371
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Country | US
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Telephone | 352-338-2195
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Fax | 352-265-0627
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP1267412
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License Number State | FL
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