Healthcare Provider Details

I. General information

NPI: 1578236907
Provider Name (Legal Business Name): STAY HEALTHY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2021
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 JOHN KNOX RD STE D101
TALLAHASSEE FL
32303-4158
US

IV. Provider business mailing address

325 JOHN KNOX RD STE D101
TALLAHASSEE FL
32303-4158
US

V. Phone/Fax

Practice location:
  • Phone: 954-873-2426
  • Fax:
Mailing address:
  • Phone: 850-755-3808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRANDI RICHARDSON
Title or Position: OWNER, APRN
Credential:
Phone: 850-329-2932