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General NPI Number Information
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NPI Number | 1619989076
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Entity Type | Individual
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Provider Name | IPATIA D MAGNUS PHD, DNP, FPMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 06/13/2023
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Provider Practice Location Address
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Address Line | 13910 FIVAY RD STE 8
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City | HUDSON
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State | FL
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Zip | 34667
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Country | US
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Telephone | 727-858-2007
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Fax | 727-862-7163
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Provider Business Mailing Address
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Address Line | 13910 FIVAY RD STE 8
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City | HUDSON
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State | FL
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Zip | 34667-7130
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Country | US
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Telephone | 727-858-2007
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Fax | 727-053-1696
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1961592
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License Number State | FL
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