Provider Demographics
NPI:1720356512
Name:ADVANCED PRACTICE NURSING SERVICES, LLC
Entity Type:Organization
Organization Name:ADVANCED PRACTICE NURSING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIFRANCES
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:GULLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-310-8766
Mailing Address - Street 1:565 MEMORIAL CIR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-5001
Mailing Address - Country:US
Mailing Address - Phone:386-310-8766
Mailing Address - Fax:386-310-8770
Practice Address - Street 1:565 MEMORIAL CIR
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5001
Practice Address - Country:US
Practice Address - Phone:386-310-8766
Practice Address - Fax:386-310-8770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2530742103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Multi-Specialty