Healthcare Provider Details

I. General information

NPI: 1679509079
Provider Name (Legal Business Name): TWYLA COTTON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14088 ALABAMA ST
JAY FL
32565-1036
US

IV. Provider business mailing address

PO BOX 10
JAY FL
32565-0010
US

V. Phone/Fax

Practice location:
  • Phone: 850-675-4546
  • Fax: 850-675-4548
Mailing address:
  • Phone: 850-675-4546
  • Fax: 850-675-4548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 805472
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: