Provider Demographics
NPI:1083959688
Name:ERNEWEIN, CHARRITA ANNIESE (ARNP)
Entity Type:Individual
Prefix:
First Name:CHARRITA
Middle Name:ANNIESE
Last Name:ERNEWEIN
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 1:2535 MASON OAKS DR
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-6498
Mailing Address - Country:US
Mailing Address - Phone:813-892-0635
Mailing Address - Fax:727-789-1010
Practice Address - Street 1:24420 SR 54
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-7303
Practice Address - Country:US
Practice Address - Phone:813-949-4100
Practice Address - Fax:813-949-4144
Is Sole Proprietor?:No
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9186728363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily