Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 2076242 | FL |
NPI | 1063421758 |
---|---|
Provider Name | Ireneanne Doyle Kittles |
First Address | Gainesville, FL 32608-1135 |
Second Address | Gainesville, FL 32608-1135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 14/04/2021 |