Provider Demographics
NPI:1629516281
Name:KOWALSKI, CLOUDIA JACQUELINE (MSN, ARNP-C)
Entity Type:Individual
Prefix:MS
First Name:CLOUDIA
Middle Name:JACQUELINE
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:MSN, ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 S MARION AVE FL 32025
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-5808
Mailing Address - Country:US
Mailing Address - Phone:386-755-3016
Mailing Address - Fax:
Practice Address - Street 1:5571 SW 64TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-9608
Practice Address - Country:US
Practice Address - Phone:352-337-4928
Practice Address - Fax:352-337-4990
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP934621207N00000X
FLARNP9346211363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology