Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | ARNP9296513 | FL |
NPI | 1023319845 |
---|---|
Provider Name | Ms. Darcy Vetro Ravndal |
First Address | Orlando, FL 32804-5831 |
Second Address | Orlando, FL 32804-3722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2010 |
Last Update Date | 24/05/2017 |