Individual
GLORIA LYNN NIQUETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
155 SE 6TH PL, LAKE BUTLER, FL 32054-2213
(386) 496-1236
Mailing address
345 W. MADISON ST, STARKE, FL 32091-3923
(904) 964-5455
(904) 964-4099
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9214471
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LICENCE NUMBER
ARNP9214471
FL
Enumeration date
08/02/2013
Last updated
07/17/2023
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