Healthcare Provider Details

I. General information

NPI: 1073847075
Provider Name (Legal Business Name): CINDY KAREN WILSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CINDY KAREN WATSON ARNP

II. Dates (important events)

Enumeration Date: 09/23/2009
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2606 CENTENNIAL PL
TALLAHASSEE FL
32308-0572
US

IV. Provider business mailing address

PO BOX 44230
JACKSONVILLE FL
32231-4230
US

V. Phone/Fax

Practice location:
  • Phone: 850-202-0189
  • Fax:
Mailing address:
  • Phone: 904-376-3800
  • Fax: 904-376-3998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9222756
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: