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NPI Code Detail

MEDICARE: ELIZABETH ANN HERNDON M.S. CF-SLP

MEDICARE: ELIZABETH ANN HERNDON M.S. CF-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSZ4280FL

General Provider Information

NPI Number : 1124211818
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ANN HERNDON M.S. CF-SLP
Provider Business Mailing Address
First Line : 4419 TRAM RD
Second Line :
City : PANAMA CITY
State : FL
Zip : 32404-2559
Country : US
Telephone Number : 850-747-5401
Fax Number : 850-747-5301
Provider Business Practice Location Address
First Line : 4419 TRAM RD
Second Line :
City : PANAMA CITY
State : FL
Zip : 32404-2559
Country : US
Telephone Number : 850-747-5401
Fax Number : 850-747-5301
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2007
Last Update Date : 08/25/2007

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Directions to “ ELIZABETH ANN HERNDON M.S. CF-SLP” Practice Location

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