Healthcare Provider Details

I. General information

NPI: 1922349315
Provider Name (Legal Business Name): TESSA MARKUM SEXTON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TESSA KAREN MARKUM ARNP

II. Dates (important events)

Enumeration Date: 03/08/2013
Last Update Date: 03/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 MAR WALT DRIVE SUITE 210
FORT WALTON BEACH FL
32547-6796
US

IV. Provider business mailing address

1005 MAR WALT DRIVE
FORT WALTON BEACH FL
32547-6796
US

V. Phone/Fax

Practice location:
  • Phone: 850-863-8260
  • Fax: 850-862-6098
Mailing address:
  • Phone: 850-863-8260
  • Fax: 850-862-6098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9353357
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: