Healthcare Provider Details

I. General information

NPI: 1528360963
Provider Name (Legal Business Name): REBECCA BREAUX PARMER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2010
Last Update Date: 08/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 N COVE BLVD
PANAMA CITY FL
32401-3642
US

IV. Provider business mailing address

PO BOX 2699
PENSACOLA FL
32513-2699
US

V. Phone/Fax

Practice location:
  • Phone: 850-785-9559
  • Fax:
Mailing address:
  • Phone: 850-475-4686
  • Fax: 850-475-4619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP3291722
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: