VA NPI 1538679576

NPI Information

VA is a licensed practical nurse in Gainesville, FL. The provider is an individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. VA NPI is 1538679576. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1601 S.W. ARCHER ROAD
GAINESVILLE, FL
ZIP 32608-197
Phone: (352) 376-1611

The provider's authorized official is Thomas Richard Obrien .
The authorized official title is Lpn and has the following contact phone number (352) 376-1611.

The CLIA number assigned to this NPI record is 10D1057631 - community clinic with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/4/2017 and was last updated on 10/4/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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