Healthcare Provider Details

I. General information

NPI: 1417862715
Provider Name (Legal Business Name): AZAIA STUBBS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N MAIN ST
CHATTAHOOCHEE FL
32324-1107
US

IV. Provider business mailing address

1245 TAPLEY TRL
TALLAHASSEE FL
32311-4239
US

V. Phone/Fax

Practice location:
  • Phone: 850-663-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11048527
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: