Individual
JILL LOGOTHETIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, CPNP
Contact information
Practice address
1530 AIRPORT BLVD, PENSACOLA, FL 32504-8616
(850) 474-4777
Mailing address
1530 AIRPORT BLVD, PENSACOLA, FL 32504-8616
(850) 474-4777
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R881494
MS
Other
Enumeration date
05/07/2015
Last updated
01/14/2020
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