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General NPI Number Information
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NPI Number | 1467789347
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Entity Type | Individual
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Provider Name | DENISE LYNN RAYCHOK ARNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/12/2009
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Last Update Date | 10/21/2011
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Provider Practice Location Address
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Address Line | 1800 SE 17TH ST SUITE 700
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City | OCALA
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State | FL
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Zip | 34471-4191
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Country | US
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Telephone | 352-789-6008
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Fax | 352-512-0510
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Provider Business Mailing Address
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Address Line | 1800 SE 17TH STREET SUITE 700
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City | OCALA
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State | FL
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Zip | 34471-4191
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Country | US
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Telephone | 352-789-6008
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Fax | 352-512-0510
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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 | ARNP3207182
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License Number State | FL
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