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General NPI Number Information
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NPI Number | 1033006283
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Entity Type | Organization
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Legal Business Name | BARN TO BEACH HEALTH & WELLNESS
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 4296 5TH AVE
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City | MARIANNA
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State | FL
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Zip | 32446-2173
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Country | US
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Telephone | 850-557-8727
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Fax |
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Provider Business Mailing Address
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Address Line | 4296 5TH AVE
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City | MARIANNA
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State | FL
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Zip | 32446-2173
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Country | US
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Telephone | 850-557-8727
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTIN FENTON
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Credential | APRN
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Telephone | 850-557-8727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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