MEDICARE: MRS. AIMIE EXLEY ENKE

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	11014260	FL
2	363L00000X	Nurse Practitioner	APRN11014260	FL
3	363L00000X	Nurse Practitioner	11014260	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11014260	OTHER	FL	BOARD OF NURSING
2	F06212624	OTHER		AANP- FNP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457936866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AIMIE EXLEY ENKE

Provider Business Mailing Address
First Line	:	123 TULIP ST
Second Line	:
City	:	NICEVILLE
State	:	FL
Zip	:	32578-3109
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7880 US HWY 98
Second Line	:
City	:	MIRAMAR BEACH
State	:	FL
Zip	:	32550-3255
Country	:	US
Telephone Number	:	850-278-3000
Fax Number	:

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

Provider Enumeration Date	:	03/17/2021
Last Update Date	:	07/23/2024

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Directions to “ MRS. AIMIE EXLEY ENKE ” Practice Location

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