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General NPI Number Information
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NPI Number | 1275463879
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Entity Type | Organization
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Legal Business Name | EC ADVANCED PRACTICE NURSING PLLC
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Dates
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Enumeration Date | 05/23/2026
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Last Update Date | 05/23/2026
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Provider Practice Location Address
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Address Line | 25 WALTER MARTIN RD NE STE 201
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City | FORT WALTON BEACH
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State | FL
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Zip | 32548-4958
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Country | US
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Telephone | 850-809-8062
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Fax |
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Provider Business Mailing Address
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Address Line | 25 WALTER MARTIN RD NE STE 201
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City | FORT WALTON BEACH
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State | FL
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Zip | 32548-4958
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Country | US
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Telephone | 850-809-8062
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. AMANDA PUETT
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Credential | FNP-C
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Telephone | 850-240-7145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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