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General NPI Number Information
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NPI Number | 1194885350
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Entity Type | Organization
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Legal Business Name | PRN OF NW FLORIDA INC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 06/25/2014
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Provider Practice Location Address
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Address Line | 2 SUGAR BOWL LANE
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City | PENSACOLA
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State | FL
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Zip | 32561
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Country | US
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Telephone | 850-723-6271
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Fax | 850-916-0788
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Provider Business Mailing Address
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Address Line | P.O. BOX 244
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City | GONZELEZ
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State | FL
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Zip | 32560
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Country | US
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Telephone | 850-723-6271
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAMES C CHANEY JR.
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Credential | ARNP
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Telephone | 850-916-0788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | ARNP 2210632
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | ARNP2210632
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License Number State | FL
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