MEDICARE: NANCY ANN MACE APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	ARNP1605302	FL

General Provider Information

NPI Number	:	1285638940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY ANN MACE APRN

Provider Business Mailing Address
First Line	:	3035 BUCKINGHAMMOCK TRL
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-4968
Country	:	US
Telephone Number	:	772-783-4001
Fax Number	:	772-778-2754

Provider Business Practice Location Address
First Line	:	3035 BUCKINGHAMMOCK TRL
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-4968
Country	:	US
Telephone Number	:	772-783-4001
Fax Number	:	772-778-2754

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	12/29/2021

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