Provider Demographics
NPI:1063870889
Name:ATWELL, DAVID A (FNP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:ATWELL
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 S GULPH RD
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3121
Mailing Address - Country:US
Mailing Address - Phone:941-748-2277
Mailing Address - Fax:941-748-1958
Practice Address - Street 1:316 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8805
Practice Address - Country:US
Practice Address - Phone:941-748-2277
Practice Address - Fax:941-748-1958
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-100230363L00000X
FLAPRN9491899363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner