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General NPI Number Information
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NPI Number | 1912903576
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Entity Type | Individual
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Provider Name | CECILIA MATHEWS ARNP
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Gender | Female
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2944 PENNSYLVANIA AVE STE L
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City | MARIANNA
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State | FL
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Zip | 32448-2741
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Country | US
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Telephone | 850-526-5500
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Fax | 850-526-5536
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Provider Business Mailing Address
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Address Line | 525 E 15TH ST
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City | PANAMA CITY
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State | FL
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Zip | 32405-5412
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Country | US
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Telephone | 850-522-4485
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Fax | 850-914-6281
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | ARNP1615692
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License Number State | FL
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