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General NPI Number Information
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NPI Number | 1710964093
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Entity Type | Individual
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Provider Name | LOUISE C WASZAK PHD, ARNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 4520 W US HIGHWAY 90
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City | LAKE CITY
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State | FL
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Zip | 32055-8341
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Country | US
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Telephone | 386-719-3939
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Fax |
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Provider Business Mailing Address
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Address Line | 525 TURKEY CREEK
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City | ALACHUA
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State | FL
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Zip | 32615
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Country | US
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Telephone | 386-462-9907
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP 009371
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP30008047
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP 9322769
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | SP002220D
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 364SM0705X
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Taxonomy Name | Medical-Surgical Clinical Nurse Specialist
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License Number | AP30008047
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License Number State | WA
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