Provider Demographics
NPI:1295840122
Name:OPUDA, ANNE CATHERINE (ARNP)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:CATHERINE
Last Name:OPUDA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:OPUDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:825 NW 23RD AVE
Mailing Address - Street 2:BLDG III SUITE A
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-3574
Mailing Address - Country:US
Mailing Address - Phone:352-376-1611
Mailing Address - Fax:352-248-0270
Practice Address - Street 1:825 NW 23RD AVE
Practice Address - Street 2:BLDG III SUITE A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-3574
Practice Address - Country:US
Practice Address - Phone:352-376-1611
Practice Address - Fax:352-248-0270
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL911112363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health