MEDICARE: MRS. DAPHNE ANITA ESSEX NP

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
1	363LF0000X	Family Nurse Practitioner	1071191	AL

General Provider Information

NPI Number	:	1225090103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAPHNE ANITA ESSEX NP

Provider Business Mailing Address
First Line	:	300 TWINING ST BLDG 760
Second Line	:
City	:	MAXWELL AFB
State	:	AL
Zip	:	36112-6027
Country	:	US
Telephone Number	:	334-953-5200
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 TWINING ST BLDG 760
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36112-6027
Country	:	US
Telephone Number	:	334-953-5200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	07/19/2022

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