Provider Demographics
NPI:1003970336
Name:MCPHERSON, DENISE M (ARNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:MCPHERSON
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:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-8250
Mailing Address - Fax:239-343-8249
Practice Address - Street 1:5225 CLAYTON CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-2117
Practice Address - Country:US
Practice Address - Phone:239-343-8250
Practice Address - Fax:239-343-8249
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 2773892363LF0000X
FLARNP2773892363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3081401000Medicaid
FLARNP2773892OtherMEDICAL LICENSE
FLAA266UMedicare UPIN
FLAA266WMedicare UPIN
FL3081401000Medicaid