Healthcare Provider Details

I. General information

NPI: 1942223680
Provider Name (Legal Business Name): SABRINA KELLEY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 03/13/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13569 PANAMA CITY BEACH PKWY
PANAMA CITY BEACH FL
32407-2847
US

IV. Provider business mailing address

13569 PANAMA CITY BEACH PKWY
PANAMA CITY BEACH FL
32407-2847
US

V. Phone/Fax

Practice location:
  • Phone: 850-238-8563
  • Fax: 850-238-8564
Mailing address:
  • Phone: 850-238-8563
  • Fax: 850-238-8564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11024688
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: