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General NPI Number Information
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NPI Number | 1669984845
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Entity Type | Individual
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Provider Name | JOHN D CHEATWOOD CRNP, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 10/28/2017
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 305 CORDAY ST
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City | PENSACOLA
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State | FL
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Zip | 32503-2214
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Country | US
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Telephone | 448-227-2100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 732892
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City | DALLAS
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State | TX
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Zip | 75373-1836
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Country | US
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Telephone | 850-469-3500
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11004292
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License Number State | FL
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