Provider Demographics
NPI:1245010495
Name:BOERSMA, ELENA (ARNP)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:BOERSMA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:
Other - Last Name:BOERSMA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:8598 SW 59TH TER
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-7807
Mailing Address - Country:US
Mailing Address - Phone:352-895-5661
Mailing Address - Fax:
Practice Address - Street 1:9401 SW HIGHWAY 200 STE 2004
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-9619
Practice Address - Country:US
Practice Address - Phone:352-897-0063
Practice Address - Fax:866-502-8021
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11028535363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner