Doctor Name: | KIRSTY FRESHWATER |
NPI Number: | 1407296726 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | ARNP9329461 |
Business Practice Address: | 1830 N Main St Bell, FL - 326194713 |
Business Phone Number: | 3524631100 |
Business Fax Number: | 3524632726 |
Mailing Address: | 911 S Main St, TRENTON |
State: | FL |
Postal Code: | 326933239 |
Phone Number: | 3524632374 |
Fax Number: | 3524632726 |
NPI Enumeration Date: | 07/01/2013 |
NPI Last Update Date: | 07/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | ARNP9329461 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |