Organization
GRACE FAMILY PRACTICE
Active
Other names
Graceland Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA ANN FICKLING APRN, FNP-C (PROVIDER)
(850) 741-2878
Entity
Organization
Contact information
Practice address
6470 TIPPIN AVE, PENSACOLA, FL 32504-8143
(850) 741-2878
Mailing address
6470 TIPPIN AVE, PENSACOLA, FL 32504-8143
(850) 741-2878
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184196669
—
FL
Enumeration date
10/22/2020
Last updated
10/22/2020
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