Healthcare Provider Details

I. General information

NPI: 1538177803
Provider Name (Legal Business Name): PATRICIA SANDERS PRINCE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 03/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 LEARNING WAY
TALLAHASSEE FL
32306-0001
US

IV. Provider business mailing address

960 LEARNING WAY
TALLAHASSEE FL
32306
US

V. Phone/Fax

Practice location:
  • Phone: 850-644-1802
  • Fax: 850-644-4251
Mailing address:
  • Phone: 229-224-1427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP518862
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: