Provider Demographics
NPI:1982072336
Name:GARLAND, NICOLE (ARNP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:GARLAND
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1173 TURNER ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-4135
Mailing Address - Country:US
Mailing Address - Phone:727-298-8496
Mailing Address - Fax:727-445-7566
Practice Address - Street 1:1173 TURNER ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-4135
Practice Address - Country:US
Practice Address - Phone:727-298-8496
Practice Address - Fax:727-445-7566
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9326325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016458200Medicaid
FL4486943438Medicare PIN