# BLUEWATER PRIMARY CARE, INC

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

## Provider details

- **NPI number:** 1831936962
- **Authorized official:** DR. LEIGH POWERS DNP, MSN, PMHNP-BC (OWNER)
- **Authorized official phone:** (755) 201-2305

## Contact information

- **Practice address:** 4400 E HIGHWAY 20 STE 313, NICEVILLE, FL 32578-7700
- **Practice address phone:** (850) 797-2598
- **Mailing address:** 4400 E HIGHWAY 20 STE 313, NICEVILLE, FL 32578-7700
- **Mailing address phone:** (575) 520-1230
- **Mailing address fax:** (773) 492-8765

## Taxonomy

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

## Other

- **Enumeration date:** 07/15/2024
- **Last updated:** 10/14/2024