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SOUTHERN PRACTITIONER
NPI 1326556200
Nurse Practitioner - Family in Pensacola, FL

Active since January 13, 2018
15 W MAXWELL ST, STE 148, PENSACOLA, FL 32501(850) 434-0077(850) 434-0220 Get Directions Write a Review

NPPES record last updated: November 22, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 22, 2022, Mar 2, 2022, Sep 9, 2020 and 2 more (5 updates tracked since 2018).

About Southern Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN PRACTITIONER (NPI 1326556200) is a healthcare organization registered as a family in Pensacola, Florida and active in the NPI registry since January 2018. The organization lists Jennifer Prince, Owner, as its authorized official.

NPPES Registry Identity

NPI1326556200
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameSOUTHERN PRACTITIONER
Location Address15 W MAXWELL ST, STE 148Pensacola, FL 32501-1717
Mailing Address904 N 75th AvePensacola, FL 32506-3820 · (850) 434-0077 · Fax (850) 434-0220
Phone(850) 434-0077
Fax(850) 434-0220
Organization SubpartNo
Authorized OfficialJennifer PrinceOwner · (850) 434-0077
Enumeration DateJanuary 13, 2018
Last NPPES UpdateNovember 22, 20225 updates tracked since enumeration
NPPES CertifiedNovember 22, 2022
✔ NPI 1326556200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in FL · 9167682
15 W MAXWELL ST, Pensacola, FL 32501
Open in Google Maps ↗

Other Identifiers 1

Medicaid111684900FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER BLANCHE SHUE APRN
Nurse Practitioner (Family)
15 W MAXWELL ST, STE 148
PENSACOLA, FL 32501
Escambia County (850) 434-0077
GADDIEL REYES
Physical Therapist
15 W MAXWELL ST
PENSACOLA, FL 32501
Escambia County (951) 240-9869

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Practitioner's NPI number?

The NPI number for Southern Practitioner is 1326556200. It was assigned to this organization in the NPPES registry on January 13, 2018.

Where is Southern Practitioner located?

Southern Practitioner is located at 15 W Maxwell St Ste 148, Pensacola, FL 32501. The listed phone number is (850) 434-0077.

What is Southern Practitioner's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Southern Practitioner was last updated on November 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.