MEDICARE: NANCY HERTL FNP-C

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	11008804	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	:	1538775879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY HERTL FNP-C

Provider Business Mailing Address
First Line	:	4354 NW 23RD AVE
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-6541
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4354 NW 23RD AVE
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-6541
Country	:	US
Telephone Number	:	352-376-4565
Fax Number	:

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

Provider Enumeration Date	:	09/22/2020
Last Update Date	:	03/11/2026

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