Healthcare Provider Details

I. General information

NPI: 1083030142
Provider Name (Legal Business Name): MARY CECILIA PRICE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2014
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8333 N DAVIS HWY FL 7
PENSACOLA FL
32514-6050
US

IV. Provider business mailing address

8333 N DAVIS HWY FL 7
PENSACOLA FL
32514-6050
US

V. Phone/Fax

Practice location:
  • Phone: 850-969-2038
  • Fax: 850-969-2037
Mailing address:
  • Phone: 850-969-2038
  • Fax: 850-969-2037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN9173932
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP 9173932
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberARNP9173932
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: