Provider Demographics
NPI:1992245088
Name:MCDUFFIE, KIA NISSAN (MSN ARNP FNP-BC)
Entity type:Individual
Prefix:MISS
First Name:KIA
Middle Name:NISSAN
Last Name:MCDUFFIE
Suffix:
Gender:F
Credentials:MSN ARNP FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:506 4TH AVE W
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-5203
Practice Address - Country:US
Practice Address - Phone:419-338-1089
Practice Address - Fax:941-933-8109
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9303986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily