Healthcare Provider Details

I. General information

NPI: 1528326030
Provider Name (Legal Business Name): DONNA LEA GARRETT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DONNA LEA COCKROFT ARNP

II. Dates (important events)

Enumeration Date: 05/03/2012
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 MARKET PLACE RD
PENSACOLA FL
32504-8986
US

IV. Provider business mailing address

PO BOX 11637
PENSACOLA FL
32524-1637
US

V. Phone/Fax

Practice location:
  • Phone: 850-484-4080
  • Fax:
Mailing address:
  • Phone: 850-484-4080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-049079
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number9352804
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: