MEDICARE: MRS. EMILY MUELLER NENNSTIEL

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	207Q00000X	Family Medicine Physician	9121249	FL

General Provider Information

NPI Number	:	1720971252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMILY MUELLER NENNSTIEL

Provider Business Mailing Address
First Line	:	317 NORTON DR STE 101
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-6044
Country	:	US
Telephone Number	:	850-702-5940
Fax Number	:	850-325-6022

Provider Business Practice Location Address
First Line	:	317 NORTON DR STE 101
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-6044
Country	:	US
Telephone Number	:	850-702-5940
Fax Number	:	850-325-6022

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

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	03/31/2026

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