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NPI Code Detail

MEDICARE: FORGET-ME-NOT DEMENTIA CLINIC AND OTHER NEUROLOGY SERVICES LLC

MEDICARE: FORGET-ME-NOT DEMENTIA CLINIC AND OTHER NEUROLOGY SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse Practitioner
2363LG0600XGerontology Nurse Practitioner
3363L00000XNurse Practitioner

General Provider Information

NPI Number : 1013866847
Entity Type Code : Organization
Provider Name (Legal Business Name) : FORGET-ME-NOT DEMENTIA CLINIC AND OTHER NEUROLOGY SERVICES LLC
Provider Business Mailing Address
First Line : 2428 JENKS AVE STE B
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4304
Country : US
Telephone Number : 850-215-4171
Fax Number : 850-215-4191
Provider Business Practice Location Address
First Line : 2428 JENKS AVE STE B
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4304
Country : US
Telephone Number : 850-215-4171
Fax Number : 850-215-4191
Authorized Official
Title or Position : CEO/OWNER
Name : JENNIFER REEVES
Credential : APRN
Telephone Number : 956-793-3562
Provider Enumeration Date : 01/26/2026
Last Update Date : 02/07/2026

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Directions to “FORGET-ME-NOT DEMENTIA CLINIC AND OTHER NEUROLOGY SERVICES LLC ” Practice Location

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