Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | ARNP2773892 | FL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | RN 2773892 | FL |
NPI | 1003970336 |
---|---|
Provider Name | Denise M Mcpherson |
First Address | Fort Myers, FL 33902-2147 |
Second Address | Fort Myers, FL 33907-2117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 29/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3081401000 | (05) | FL |
AA266U | (02) | FL |
AA266W | (02) | FL |
ARNP2773892 | MEDICAL LICENSE (01) | FL |
Q74539 | (02) | FL |