Healthcare Provider Details

I. General information

NPI: 1528923877
Provider Name (Legal Business Name): JUBILEE WELLNESS COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10508 S BEAR CREEK RD
PANAMA CITY FL
32404-4816
US

IV. Provider business mailing address

10508 S BEAR CREEK RD
PANAMA CITY FL
32404-4816
US

V. Phone/Fax

Practice location:
  • Phone: 850-819-5241
  • Fax:
Mailing address:
  • Phone: 850-819-5241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CRISTINA STEVENSON
Title or Position: CEO, OWNER
Credential: APRN, PMHNP, CNM
Phone: 850-819-5241