MEDICARE: KRISTEN BRYAN FLOYD ARNP

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
1	363L00000X	Nurse Practitioner	ARNP3173822	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ARNP3173822	OTHER	FL	LICENCE
2	Y048W	OTHER	FL	BLUE CROSS

General Provider Information

NPI Number	:	1295805398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN BRYAN FLOYD ARNP

Provider Business Mailing Address
First Line	:	320 E 19TH ST
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4718
Country	:	US
Telephone Number	:	850-769-2757
Fax Number	:	850-769-2455

Provider Business Practice Location Address
First Line	:	320 E 19TH ST
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4718
Country	:	US
Telephone Number	:	850-769-2757
Fax Number	:	850-769-2455

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	05/02/2008

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