Individual
MRS. STACCIE ANNE ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
922 E CALL ST, STARKE, FL 32091-3616
(904) 368-2300
Mailing address
2323 NW 93RD ST, GAINESVILLE, FL 32606-7146
(352) 258-3726
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
ARNP9203022
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012424100
—
FL
Enumeration date
06/26/2014
Last updated
01/19/2015
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