MEDICARE: MARY M ANDREWS ARNP

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	ARNP9266378	FL

General Provider Information

NPI Number	:	1487977757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY M ANDREWS ARNP

Provider Business Mailing Address
First Line	:	2428 JENKS AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4304
Country	:	US
Telephone Number	:	850-788-3120
Fax Number	:	850-788-3125

Provider Business Practice Location Address
First Line	:	2428 JENKS AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4304
Country	:	US
Telephone Number	:	850-788-3120
Fax Number	:	850-788-3125

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

Provider Enumeration Date	:	03/01/2010
Last Update Date	:	05/20/2020

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