Southern Practitioner

LBN: Southern Practitioner
Southern Practitioner is an health care organization with primary practice located at 15 W Maxwell St Ste 148, Pensacola FL 32501-1717. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as the primary health care specialty. Southern Practitioner can be contacted via phone (850) 434-0077, or through Prince, Jennifer via phone (850) 434-0077.

Contact Information

Primary practice address
15 W Maxwell St Ste 148 Pensacola FL 32501-1717
Phone: (850) 434-0077
Fax: (850) 434-0220
Website:
Map and Directions
Authorized official contact:
Name: Prince, Jennifer ARNP
Phone: (850) 434-0077

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 9167682 Florida

Profile Details

NPI number 1326556200
LBN Legal business name Southern Practitioner
DBA Doing business as
Authorized official Prince, Jennifer ARNP
Entity Organization
Organization subpart 1 No
Enumeration date Jan 13th, 2018
Last updated Nov 22nd, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326556200 NPPES
Florida MEDICAID 111684900

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