Healthcare Provider Details

I. General information

NPI: 1568385003
Provider Name (Legal Business Name): PANAMA CITY PRIMARY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 JENKS AVE
PANAMA CITY FL
32401-2438
US

IV. Provider business mailing address

1145 JENKS AVE
PANAMA CITY FL
32401-2438
US

V. Phone/Fax

Practice location:
  • Phone: 850-814-0803
  • Fax: 850-732-8663
Mailing address:
  • Phone: 850-814-0803
  • Fax: 850-732-8663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LAUREN SAULS
Title or Position: NURSE PRACTITIONER
Credential: APRN-C
Phone: 850-814-0803