=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609203405
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | APPEAL NOW LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/11/2013
-----------------------------------------------------
Last Update Date | 10/11/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7100 TIPPIN AVE APT B
-----------------------------------------------------
City | PENSACOLA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32504-6585
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-266-7699
-----------------------------------------------------
Fax | 866-632-5816
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 10507
-----------------------------------------------------
City | PENSACOLA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32524-0507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-266-7699
-----------------------------------------------------
Fax | 866-632-5816
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | KIMBERLY ANN SAMPSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 850-266-7699
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251X00000X
-----------------------------------------------------
Taxonomy Name | Supports Brokerage Agency
-----------------------------------------------------
License Number | 251X00000X
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------