Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | ARNP1966002 | FL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP1966002 | FL |
N | 363LP0200X | Nurse Practitioner - Pediatrics | ARNP1966002 | FL |
NPI | 1205030426 |
---|---|
Provider Name | Ronalda Futtrell-Hobson |
First Address | St Petersburg, FL 33701-3109 |
Second Address | St Petersburg, FL 33701-3109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2007 |
Last Update Date | 08/07/2007 |