MEDICARE: RONDA TOOLE APRN

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	APRN-11028345	FL
2	163W00000X	Registered Nurse	RN113445	GA
3	363LF0000X	Family Nurse Practitioner	RN113445	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00363830	OTHER	GA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467491290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONDA TOOLE APRN

Provider Business Mailing Address
First Line	:	12234 PANAMA CITY BEACH PKWY
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32407-2725
Country	:	US
Telephone Number	:	850-233-2323
Fax Number	:	850-233-1055

Provider Business Practice Location Address
First Line	:	12234 PANAMA CITY BEACH PKWY
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32407-2725
Country	:	US
Telephone Number	:	850-233-2323
Fax Number	:	850-233-1055

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	12/14/2023

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Directions to “ RONDA TOOLE APRN” Practice Location

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