Provider Demographics
NPI:1518622448
Name:GACHETTE, LEATRICE (MSN, APRN, CNM)
Entity Type:Individual
Prefix:
First Name:LEATRICE
Middle Name:
Last Name:GACHETTE
Suffix:
Gender:F
Credentials:MSN, APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 NORTH BLVD W
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-8990
Mailing Address - Country:US
Mailing Address - Phone:863-421-7600
Mailing Address - Fax:863-421-7551
Practice Address - Street 1:2221 NORTH BLVD W
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-8990
Practice Address - Country:US
Practice Address - Phone:863-421-7600
Practice Address - Fax:863-421-7551
Is Sole Proprietor?:No
Enumeration Date:2021-11-04
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016341367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife