Provider Demographics
NPI:1801371802
Name:CITY OF GAINESVILLE
Entity Type:Organization
Organization Name:CITY OF GAINESVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:COLETTE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:352-334-5037
Mailing Address - Street 1:222 E UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-5456
Mailing Address - Country:US
Mailing Address - Phone:352-334-5037
Mailing Address - Fax:352-334-5037
Practice Address - Street 1:222 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-5456
Practice Address - Country:US
Practice Address - Phone:352-334-5037
Practice Address - Fax:352-334-5037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-26
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine