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Organization

ANKLE & FOOT SPECIALISTS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KINLEY WAYNE HOWARD D.P.M, C.R.N.A. (OWNER)
(850) 497-8876
Entity
Organization

Contact information

Practice address
12385 SORRENTO RD, SUITE D-4, PENSACOLA, FL 32507-8664
(850) 497-8876
(850) 497-1721
Mailing address
12385 SORRENTO RD, SUITE D-4, PENSACOLA, FL 32507-8664
(850) 497-8876
(850) 497-1721

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO2112
FL
363L00000X
Nurse Practitioner
ARNP2539562
FL
367500000X
Certified Registered Nurse Anesthetist
ARNP2539562
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10729640
CAQH
FL
05
307772100
FL
05
340655500
FL
Enumeration date
09/16/2008
Last updated
09/15/2011
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