Graceland Family Practice

LBN: Graceland Family Practice
Graceland Family Practice is an health care organization with primary practice located at 6470 Tippin Ave , Pensacola FL 32504-8143. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Graceland Family Practice can be contacted via phone (850) 741-2878, or through Fickling, Debra Ann via phone (850) 741-2878.

Contact Information

Primary practice address
6470 Tippin Ave Pensacola FL 32504-8143
Phone: (850) 741-2878
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Fickling, Debra Ann Advanced Practice Registered Nurse (APRN)
Phone: (850) 741-2878

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1881293587
LBN Legal business name Graceland Family Practice
DBA Doing business as
Authorized official Fickling, Debra Ann Advanced Practice Registered Nurse (APRN)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 22nd, 2020
Last updated Oct 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881293587 NPPES
Florida MEDICAID 1184196669

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