Provider Demographics
NPI:1407622236
Name:VILDOR, NITSHELL KERIN (APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:NITSHELL
Middle Name:KERIN
Last Name:VILDOR
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3385 S US HIGHWAY 17/92 STE 285
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-2916
Mailing Address - Country:US
Mailing Address - Phone:407-883-0908
Mailing Address - Fax:
Practice Address - Street 1:3385 S US HIGHWAY 17/92 STE 285
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-2916
Practice Address - Country:US
Practice Address - Phone:407-883-0908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11030443363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily