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General NPI Number Information
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NPI Number | 1376857839
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Entity Type | Individual
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Provider Name | GRACE-ANN SUTHERLAND ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/27/2010
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 2600 WESTHALL LN
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City | MAITLAND
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State | FL
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Zip | 32751-7102
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Country | US
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Telephone | 407-245-4921
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 DARDEN CENTER DR
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City | ORLANDO
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State | FL
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Zip | 32837-4032
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Country | US
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Telephone | 407-245-4921
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Fax | 407-245-4924
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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 | 3314612
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License Number State | FL
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