Healthcare Provider Details

I. General information

NPI: 1629390802
Provider Name (Legal Business Name): MARTHA A ATKINSON CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E. 6TH STREET SUITE 302
PANAMA CITY FL
32401-3663
US

IV. Provider business mailing address

PO BOX 11407
BIRMINGHAM AL
35246-1431
US

V. Phone/Fax

Practice location:
  • Phone: 850-763-6224
  • Fax: 850-872-1623
Mailing address:
  • Phone: 888-313-5258
  • Fax: 205-313-5245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN1736292
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: