MEDICARE: CATHLEEN CHICOINE

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	ARNP9318496	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417499542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHLEEN CHICOINE

Provider Business Mailing Address
First Line	:	2101 GREENWAY DR
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-1257
Country	:	US
Telephone Number	:	863-969-9625
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 S MISSOURI AVE
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33815-4600
Country	:	US
Telephone Number	:	863-583-7100
Fax Number	:

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

Provider Enumeration Date	:	11/07/2016
Last Update Date	:	08/25/2025

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Directions to “ CATHLEEN CHICOINE ” Practice Location

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