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General NPI Number Information
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NPI Number | 1548102676
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Entity Type | Organization
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Legal Business Name | SERVANT HEART COLLABORATIVE CARE, LLC.
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/07/2026
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Provider Practice Location Address
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Address Line | 2460 N COURTENAY PKWY STE 101
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City | MERRITT ISLAND
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State | FL
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Zip | 32953-4193
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Country | US
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Telephone | 321-431-0529
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Fax |
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Provider Business Mailing Address
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Address Line | 2460 N COURTENAY PKWY STE 101
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City | MERRITT ISLAND
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State | FL
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Zip | 32953-4193
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Country | US
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Telephone | 321-431-0529
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER/PRACTICE OWNER
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Name | STACY FIFER
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Credential | APRN-C
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Telephone | 321-431-0529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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