Provider Demographics
NPI:1124459920
Name:ALFORD, CONSTANCE MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:MARIE
Last Name:ALFORD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:CONSTANCE
Other - Middle Name:MARIE
Other - Last Name:STICHWEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 SW ARCHER RD BOX 100298
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-3003
Mailing Address - Country:US
Mailing Address - Phone:352-273-9120
Mailing Address - Fax:352-273-5941
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:BOX 100296
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-273-9120
Practice Address - Fax:352-273-5941
Is Sole Proprietor?:No
Enumeration Date:2013-12-03
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9191069363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010421400Medicaid
FL010421400Medicaid