NPI 1003528258 · live from the CMS NPI Registry
12th Avenue Healthcare, INC
Nurse Practitioner, Family in Pensacola, FL. National Provider Identifier 1003528258, active.
NPI record
| NPI | 1003528258 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 1101 Office Woods Dr, Pensacola, FL 32504 |
| Practice phone | 850-776-7872 |
| Mailing address | 9735 N Palafox St, Pensacola, FL 32534 |
| Enumerated | December 20, 2022 |
| Last updated | December 20, 2022 |
| Authorized official | Emily Stinnett, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Family primary | 363LF0000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.