Individual
PENNY N ERVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., R.N.F.A
Contact information
Practice address
6440 W NEWBERRY RD, SUITE 401, GAINESVILLE, FL 32605-4381
(352) 332-0030
(352) 332-0039
Mailing address
PO BOX 15, ALACHUA, FL 32616-0015
(386) 462-5077
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN 3062222
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN 3062222
MEDICAL LICENSE
FL
Enumeration date
04/11/2007
Last updated
06/16/2010
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