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General NPI Number Information
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NPI Number | 1477944122
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Entity Type | Individual
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Provider Name | ROBERT BRIAN JUSTICE ARNP
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Gender | Male
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Dates
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Enumeration Date | 02/16/2015
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Last Update Date | 02/16/2015
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Provider Practice Location Address
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Address Line | 514 MARY ESTHER CUT OFF NW
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City | FORT WALTON BEACH
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State | FL
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Zip | 32548-4025
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Country | US
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Telephone | 850-226-8550
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Fax | 850-226-6712
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Provider Business Mailing Address
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Address Line | 4763 MELISSA CV
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City | CRESTVIEW
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State | FL
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Zip | 32539-8360
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Country | US
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Telephone | 850-699-0897
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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 | ARNP9182283
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License Number State | FL
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