Healthcare Provider Details

I. General information

NPI: 1831713619
Provider Name (Legal Business Name): JENNIFER GABRIELE POSTON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2020
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 W BALDWIN RD
PANAMA CITY FL
32405-3333
US

IV. Provider business mailing address

625 W BALDWIN RD STE C
PANAMA CITY FL
32405-3359
US

V. Phone/Fax

Practice location:
  • Phone: 850-769-0329
  • Fax:
Mailing address:
  • Phone: 850-769-0329
  • Fax: 844-212-7396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11007426
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: