Healthcare Provider Details
I. General information
NPI: 1952069346
Provider Name (Legal Business Name): ELIZABETH ANN JANDURA APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/02/2021
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9292 SHOAL CREEK DR
TALLAHASSEE FL
32312-4277
US
IV. Provider business mailing address
1116 HIGH ST
PANAMA CITY FL
32404-7016
US
V. Phone/Fax
- Phone: 850-966-2145
- Fax: 833-314-0408
- Phone: 850-549-7035
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 11028835 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: