Healthcare Provider Details

I. General information

NPI: 1740425446
Provider Name (Legal Business Name): MARTHA W ALEXANDER ARNP - FAMILY NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2008
Last Update Date: 01/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1723 MAHAN CENTER BLVD BIG BEND HOSPICE
TALLAHASSEE FL
32308-5428
US

IV. Provider business mailing address

1723 MAHAN CENTER BLVD
TALLAHASSEE FL
32308-5428
US

V. Phone/Fax

Practice location:
  • Phone: 850-445-7265
  • Fax: 850-309-1638
Mailing address:
  • Phone: 850-878-5310
  • Fax: 850-309-1638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberARNP1795682
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP1795682
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: