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General NPI Number Information
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NPI Number | 1184438731
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Entity Type | Organization
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Legal Business Name | FOUR PILLARS HEALTHCARE PLLC
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 272 FOREST PARK CIRCLE
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City | PANAMA CITY
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State | FL
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Zip | 32405
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Country | US
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Telephone | 850-273-6131
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Fax | 850-404-5322
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Provider Business Mailing Address
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Address Line | 272 FOREST PARK CIRCLE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4216
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Country | US
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Telephone | 850-273-6131
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Fax | 850-407-5322
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Authorized Official
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Title or Position | MANAGER
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Name | MS. SAMANTHA PATE
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Credential | APRN, FNP-BC
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Telephone | 850-532-8485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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