Provider Demographics
NPI:1366185977
Name:CORRIVEAU, ABIGAIL IVY (APRN)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:IVY
Last Name:CORRIVEAU
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:IVY
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P O BOX 112742
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-2742
Mailing Address - Country:US
Mailing Address - Phone:352-294-5400
Mailing Address - Fax:
Practice Address - Street 1:3009 SW WILLISTON RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-3928
Practice Address - Country:US
Practice Address - Phone:352-294-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11018132363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology