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NPI 1548092661 · Nurse Practitioner · Ellenton, FL
Provider details
- NPI number
- 1548092661
- Entity type
- Individual
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- APRN11034691 (FL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5970 Willows Bridge Loop
Ellenton, FL 34222-5217
Phone: (239) 878-8642
Street-level locationGet directions
Mailing address
1631 Heathermoor Way
Dacula, GA 30019-7252
Additional practice locations (1)
- 1631 Heathermoor WayDacula, GA 30019-7252Phone: (239) 878-8642
Registry dates
- Enumerated
- 2024-08-16
- Last updated
- 2024-08-16
- Certified
- 2024-08-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.