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Organization

MENDING HEARTS PRIMARY CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHANIE BAILEY NP (OWNER)
(570) 236-2113
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary

Other

Enumeration date
12/18/2023
Last updated
12/18/2023
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