# MENDING HEARTS PRIMARY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245008333
- **Authorized official:** STEPHANIE BAILEY NP (OWNER)
- **Authorized official phone:** (570) 236-2113

## Contact information

- **Practice address:** 7901 4TH ST N STE 8298, ST PETERSBURG, FL 33702-4305
- **Practice address phone:** (570) 236-2111
- **Mailing address:** 7901 4TH ST N STE 8298, ST PETERSBURG, FL 33702-4305
- **Mailing address phone:** (570) 236-2111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/18/2023
- **Last updated:** 12/18/2023