Provider Demographics
NPI:1407893571
Name:NOON, KEVIN PATRICK (ARNP)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:PATRICK
Last Name:NOON
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2651 SW 32ND PL
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471
Mailing Address - Country:US
Mailing Address - Phone:352-401-7552
Mailing Address - Fax:352-622-7945
Practice Address - Street 1:2651 SW 32ND PL
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-401-7552
Practice Address - Fax:352-622-7945
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2827702363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00648065OtherRAIL ROAD MEDICARE
FL000078600Medicaid
FLE2660UMedicare PIN
FLE2660RMedicare PIN
FLS82198Medicare UPIN
FLE2660VMedicare PIN