Provider Demographics
NPI:1841235983
Name:NALDUCCI, MARY LOU (ARNP)
Entity Type:Individual
Prefix:
First Name:MARY LOU
Middle Name:
Last Name:NALDUCCI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 LOVELAND BLVD.
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33980
Mailing Address - Country:US
Mailing Address - Phone:941-743-6866
Mailing Address - Fax:941-743-8598
Practice Address - Street 1:19531 COCHRAN BLVD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-2081
Practice Address - Country:US
Practice Address - Phone:941-255-3535
Practice Address - Fax:941-766-7999
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00012901176B00000X
FLARNP9278345363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No176B00000XOther Service ProvidersMidwife