Provider Demographics
NPI:1174597041
Name:MCGARRAH, ANTONIA L (ARNP)
Entity type:Individual
Prefix:
First Name:ANTONIA
Middle Name:L
Last Name:MCGARRAH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ANTONIA
Other - Middle Name:L
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1750 N 50TH ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-3104
Mailing Address - Country:US
Mailing Address - Phone:813-247-4480
Mailing Address - Fax:813-247-4480
Practice Address - Street 1:1750 N 50TH ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-3104
Practice Address - Country:US
Practice Address - Phone:813-247-4480
Practice Address - Fax:813-247-4480
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2068512363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily