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General NPI Number Information
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NPI Number | 1063408904
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Entity Type | Individual
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Provider Name | ALEXIS D. GAUTHIER ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 06/16/2010
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Provider Practice Location Address
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Address Line | 25 DOCTORS DR
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City | PANAMA CITY
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State | FL
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Zip | 32405-4520
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Country | US
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Telephone | 850-785-0515
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Fax | 850-763-8400
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Provider Business Mailing Address
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Address Line | 25 DOCTORS DR
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City | PANAMA CITY
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State | FL
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Zip | 32405-4520
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Country | US
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Telephone | 850-785-0515
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Fax | 850-763-8400
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | ARNP827662
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License Number State | FL
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