Healthcare Provider Details

I. General information

NPI: 1477321982
Provider Name (Legal Business Name): PAIGE ELIZABETH WARD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAIGE BRACKIN RN

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 12/13/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 N 9TH AVE
PENSACOLA FL
32503-5926
US

IV. Provider business mailing address

6131 ARBUTUS DR
PENSACOLA FL
32504-7612
US

V. Phone/Fax

Practice location:
  • Phone: 850-361-7250
  • Fax:
Mailing address:
  • Phone: 361-442-0559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11030125
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: