MEDICARE: DR. LOUISE C WASZAK PHD, ARNP, FNP-BC

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	SP 009371	PA
2	363LF0000X	Family Nurse Practitioner	AP30008047	WA
3	363LF0000X	Family Nurse Practitioner	ARNP 9322769	FL
4	363LP0200X	Pediatric Nurse Practitioner	SP002220D	PA
5	364SM0705X	Medical-Surgical Clinical Nurse Specialist	AP30008047	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	G8871962	OTHER	WA	NEW MEDICARE SNO. CO
5	G8871961	OTHER	WA	NEW MEDICARE KING CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	230417	OTHER		L&I
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	8946801	OTHER		CRIME VICTIMS
6	0211088-06	OTHER	MD	ANCC PNP CERT
7	2006009683	OTHER	MD	ANCC FNP CERT
8	20060018	OTHER	MD	PNCB AC-PNP CERT

General Provider Information

NPI Number	:	1710964093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUISE C WASZAK PHD, ARNP, FNP-BC

Provider Business Mailing Address
First Line	:	525 TURKEY CREEK
Second Line	:
City	:	ALACHUA
State	:	FL
Zip	:	32615
Country	:	US
Telephone Number	:	386-462-9907
Fax Number	:

Provider Business Practice Location Address
First Line	:	4520 W US HIGHWAY 90
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32055-8341
Country	:	US
Telephone Number	:	386-719-3939
Fax Number	:

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	03/07/2023

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