Provider Demographics
NPI:1548205388
Name:O'DONNELL, CRISTI LAVERNE (ARNP)
Entity type:Individual
Prefix:MS
First Name:CRISTI
Middle Name:LAVERNE
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:CRISTI
Other - Middle Name:L
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 100296
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0296
Mailing Address - Country:US
Mailing Address - Phone:352-265-0222
Mailing Address - Fax:352-265-1068
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-273-8985
Practice Address - Fax:352-273-9054
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9179761363LN0000X
FLARNP9179761363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307840000Medicaid
FLAB043ZMedicare PIN
AB043YMedicare PIN