MALLORY M GUSTAFSON (NPI# 1144728486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144728486 |
| Entity Type | Individual |
| Full Name | MALLORY M GUSTAFSON |
| Credential | ARNP |
| Practice Address |
632 E Victoria Trails Blvd Deland FL 32724-7911 |
| Practice Telephone | 9704430948 |
| Mailing Telephone | 9704430948 |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2018-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP9383627 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
632 E VICTORIA TRAILS BLVD |
| City | DELAND |
| State | FL |
| Zip Code | 32724-7911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528549490 | Ultra Health Providers of Florida | Internal Medicine | 105 Asterbrooke Dr, Deland, FL 32724 | 2018-08-28 |
| 1811473275 | April Gustafson | Nurse Practitioner | 557 Adenmore Ter, Deland, FL 32724 | 2018-07-18 |
| 1245720820 | Total Renal Laboratories Inc | Clinical Medical Laboratory | 3000 Davita Way, Deland, FL 32724 | 2018-05-18 |
| 1790294742 | Deland Manor Assisted Living Corp | Assisted Living Facility | 245 S. Amelia Ave, Deland, FL 32724 | 2017-09-21 |
| 1639617954 | Starting Point Mental Health, LLC | Counselor | 620 East New York Ave Ste B, Deland, FL 32724 | 2017-02-07 |
| 1255877221 | Emily Eunice | Specialist/Technologist | 2589 W Lake Dr., Deland, FL 32724 | 2017-01-13 |
| 1073960357 | Robert Solomon Jr. | Family Medicine | 1431 Orange Camp Rd Ste 118119, Deland, FL 32724 | 2016-05-17 |
| 1730535568 | Harold Alexander | Hearing Instrument Specialist | 124 S. Amelia Ave, Unit #b, Deland, FL 32724 | 2016-05-11 |
| 1720406747 | Angel Care Homes LLC | Assisted Living Facility | 1349 E. Wisconsin Avenue, Deland, FL 32724 | 2014-04-07 |
| 1508298860 | Lindenlea Assisted Living Inc. | Assisted Living Facility | 1180 Jackson Ranch Rd, Deland, FL 32724 | 2013-08-08 |
| Find all providers in zip 32724 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609407766 | Michelle Rene' Tutt | Nurse Practitioner | 1590 South State Hwy 15a, Deland, FL 32720 | 2020-01-28 |
| 1811473275 | April Gustafson | Nurse Practitioner | 557 Adenmore Ter, Deland, FL 32724 | 2018-07-18 |
| 1659884534 | Gemma Mercado Villapando | Nurse Practitioner | 129 Gladesdown Ct, Deland, FL 32724-7954 | 2017-11-14 |
| 1487103230 | Kimberly Huber | Nurse Practitioner | 614 Brookfield Ter, Deland, FL 32724-7725 | 2016-09-21 |
| 1174916480 | Brooke A Powell | Nurse Practitioner | 612 W New York Ave, Deland, FL 32720-5274 | 2015-03-11 |
| 1891198206 | Barbara Ann Thomason | Nurse Practitioner | 905 Lake Lindley Dr N, Deland, FL 32724-4103 | 2014-09-29 |
| 1316263486 | Candice Michele Ings-jackson | Nurse Practitioner | 1070 N Stone St Ste D, Deland, FL 32720-0824 | 2010-04-14 |
| 1245798206 | Apryl D Jania | Nurse Practitioner | 701 W Plymouth Ave, Deland, FL 32720 | 2019-03-08 |
| 1992271134 | Morgan Thomas | Nurse Practitioner | 201 W Plymouth Ave, Deland, FL 32720-2753 | 2018-10-15 |
| 1528586310 | Samantha Torres | Nurse Practitioner | 929 N Spring Garden Ave Ste 170, Deland, FL 32720-0917 | 2017-09-01 |
| Find all providers in DELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.