Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 11011614 | FL |
NPI | 1023601762 |
---|---|
Provider Name | Amber Lynn Reffitt |
First Address | Clermont, FL 34711-7338 |
Second Address | Clermont, FL 34711-1978 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2021 |
Last Update Date | 13/02/2021 |