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Individual

RAE TEAF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
4945 SW 49TH PL, OCALA, FL 34474-9673
(352) 237-9430
(352) 237-9698
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 274-8200

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN11022321
FL
363L00000X
Nurse Practitioner
RN244773
GA
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN11022321
FL

Other

Enumeration date
08/25/2020
Last updated
04/17/2025
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