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General NPI Number Information
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NPI Number | 1255849246
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Entity Type | Individual
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Provider Name | DIA BOBB FNP
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Gender | Female
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Dates
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Enumeration Date | 01/12/2018
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 36468 EMERALD COAST PKWY STE 7102
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City | DESTIN
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State | FL
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Zip | 32541-0712
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Country | US
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Telephone | 850-842-3256
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Fax | 850-353-2561
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Provider Business Mailing Address
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Address Line | 437 CARDINAL AVE
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City | FORT WALTON BEACH
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State | FL
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Zip | 32548-6939
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Country | US
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Telephone | 850-502-4402
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP2732132
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License Number State | FL
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