Provider Demographics
NPI:1144707183
Name:TROUP, KEVIN (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:TROUP
Suffix:
Gender:M
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 SE MAGNOLIA EXT UNIT 1
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-3770
Mailing Address - Country:US
Mailing Address - Phone:352-401-1218
Mailing Address - Fax:352-401-1017
Practice Address - Street 1:1234 SE MAGNOLIA EXT UNIT 1
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-3770
Practice Address - Country:US
Practice Address - Phone:352-401-1218
Practice Address - Fax:352-401-1017
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9374283207Q00000X, 363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104078500Medicaid