Provider Demographics
NPI:1891985867
Name:WAITE, ANNMARIE VERONICA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ANNMARIE
Middle Name:VERONICA
Last Name:WAITE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 SUNTREE PL
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7689
Mailing Address - Country:US
Mailing Address - Phone:321-259-1883
Mailing Address - Fax:321-259-2450
Practice Address - Street 1:2 SUNTREE PL
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7689
Practice Address - Country:US
Practice Address - Phone:321-259-1883
Practice Address - Fax:321-259-2450
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2727442363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner