Healthcare Provider Details

I. General information

NPI: 1982154654
Provider Name (Legal Business Name): AUTUMN CAUGHEY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 07/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5992 BERRYHILL RD STE 302
MILTON FL
32570
US

IV. Provider business mailing address

PO BOX 2699
PENSACOLA FL
32513-2699
US

V. Phone/Fax

Practice location:
  • Phone: 850-416-4620
  • Fax: 850-623-3541
Mailing address:
  • Phone: 850-416-2000
  • Fax: 850-416-2080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP1089132
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: