Healthcare Provider Details

I. General information

NPI: 1841162302
Provider Name (Legal Business Name): KEISHA-GAYE ALEXIA PINNOCK APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

978 NW 126TH TER
CORAL SPRINGS FL
33071-4435
US

IV. Provider business mailing address

978 NW 126 TERRACE CORAL SPRINGS
CORAL SPRINGS FL
33071-4435
US

V. Phone/Fax

Practice location:
  • Phone: 954-504-3887
  • Fax:
Mailing address:
  • Phone: 954-504-3887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11042078
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: