Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | ARNP810032 | FL |
NPI | 1073598009 |
---|---|
Provider Name | Janice Tate Hoff |
First Address | Pensacola, FL 32514-1683 |
Second Address | Pensacola, FL 32514-1683 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 26/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
303004100 | (05) | FL |
P14627 | (02) | |
Y9012 | FLORIDA BLUE (01) | FL |