Individual
MS. ELIZABETH GAYLE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP-C
Contact information
Practice address
1005 MAR WALT DRIVE, CARE COORDINATION DEPARTMENT, FORT WALTON BEACH, FL 32547-6796
(850) 863-8202
(850) 862-6198
Mailing address
1005 MAR WALT DRIVE, INTERNAL MEDICINE DEPARTMENT, FORT WALTON BEACH, FL 32547-6796
(850) 863-8202
(850) 862-6148
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP3412702
FL
363LA2200X
Adult Health Nurse Practitioner
ARNP3412702
FL
363LP2300X
Primary Care Nurse Practitioner
ARNP3412702
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014192700
—
FL
01
—
Y0R4T
FLORIDA BLUE
FL
Enumeration date
09/20/2014
Last updated
10/31/2018
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