MEDICARE: EDELINE DARDIGNAC ARNP

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	163WG0000X	General Practice Registered Nurse	RN9163120	FL
2	163WI0500X	Infusion Therapy Registered Nurse	RN9163120	FL
3	163WX0200X	Oncology Registered Nurse	RN9163120	FL
4	207QA0505X	Adult Medicine Physician	ARNP9163120	FL
5	207QG0300X	Geriatric Medicine (Family Medicine) Physician	ARNP9163120	FL
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	ARNP9163120	FL
7	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	ARNP 9163120	FL
8	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist	APRN9163120	FL
9	363LF0000X	Family Nurse Practitioner	APRN9163120	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	:	1639306939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDELINE DARDIGNAC ARNP

Provider Business Mailing Address
First Line	:	2642 EAGLE LAKE DR
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-6325
Country	:	US
Telephone Number	:	352-234-8612
Fax Number	:

Provider Business Practice Location Address
First Line	:	2642 EAGLE LAKE DR
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711
Country	:	US
Telephone Number	:	352-234-8612
Fax Number	:

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

Provider Enumeration Date	:	06/15/2009
Last Update Date	:	05/26/2022

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