Healthcare Provider Details

I. General information

NPI: 1558356428
Provider Name (Legal Business Name): LEIF ERIK STERNUNG APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 S PALAFOX ST UNIT 300
PENSACOLA FL
32502-5905
US

IV. Provider business mailing address

890 S PALAFOX ST UNIT 300
PENSACOLA FL
32502-5905
US

V. Phone/Fax

Practice location:
  • Phone: 850-433-1656
  • Fax: 850-433-1996
Mailing address:
  • Phone: 850-433-1656
  • Fax: 850-433-1996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP3333912
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3333912
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: