Healthcare Provider Details

I. General information

NPI: 1427871821
Provider Name (Legal Business Name): ALEXA T ATCHLEY APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3696 GULF BREEZE PKWY
GULF BREEZE FL
32563
US

IV. Provider business mailing address

725 ROCKLAND ST
CANTONMENT FL
32533-6562
US

V. Phone/Fax

Practice location:
  • Phone: 850-710-3064
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11033911
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: