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General NPI Number Information
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NPI Number | 1396994166
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Entity Type | Organization
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Legal Business Name | ANKLE & FOOT SPECIALISTS PA
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 09/15/2011
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Provider Practice Location Address
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Address Line | 12385 SORRENTO RD SUITE D-4
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City | PENSACOLA
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State | FL
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Zip | 32507-8664
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Country | US
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Telephone | 850-497-8876
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Fax | 850-497-1721
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Provider Business Mailing Address
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Address Line | 12385 SORRENTO RD SUITE D-4
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City | PENSACOLA
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State | FL
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Zip | 32507-8664
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Country | US
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Telephone | 850-497-8876
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Fax | 850-497-1721
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Authorized Official
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Title or Position | OWNER
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Name | DR. KINLEY WAYNE HOWARD
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Credential | D.P.M, C.R.N.A.
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Telephone | 850-497-8876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP2539562
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP2539562
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO2112
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License Number State | FL
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