MEDICARE: BRIANNA NICOLE CLAYTON 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	APRN11028271	FL

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

General Provider Information

NPI Number	:	1598549933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA NICOLE CLAYTON APRN

Provider Business Mailing Address
First Line	:	911 CONE AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32401-2942
Country	:	US
Telephone Number	:	850-866-6287
Fax Number	:

Provider Business Practice Location Address
First Line	:	638 HARRISON AVE # 102
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32401-2662
Country	:	US
Telephone Number	:	850-588-4400
Fax Number	:

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

Provider Enumeration Date	:	08/24/2023
Last Update Date	:	01/24/2024

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