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Individual

MRS. MARY KATHRYN ELLERMEYER-STAPLETON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP-C, ANP

Contact information

Practice address
1700 BAKER AVE, HAINES CITY, FL 33844-8839
(863) 421-3204
Mailing address
PO BOX 91630, LAKELAND, FL 33804-1630
(863) 660-2673

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP2513482
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
014115400
FL
Enumeration date
02/12/2011
Last updated
09/20/2016
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