Healthcare Provider Details

I. General information

NPI: 1841235728
Provider Name (Legal Business Name): BARBARA PEEPLES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 02/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 ROBERTS DR STE 206
JACKSONVILLE BEACH FL
32250-3209
US

IV. Provider business mailing address

PO BOX 25317
TAMPA FL
33622-5317
US

V. Phone/Fax

Practice location:
  • Phone: 904-247-1456
  • Fax: 904-247-2281
Mailing address:
  • Phone: 813-286-0033
  • Fax: 813-282-1806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAPRN628802
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: