Organization
NORTHWEST FLORIDA HEALTHCARE, INC.
Active
Other names
Chipley Medical Group-MH
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN LISENBY (CHIEF FINANCIAL OFFICER)
(850) 415-8107
Entity
Organization
Contact information
Practice address
1376 BRICKYARD RD, CHIPLEY, FL 32428-6391
(850) 638-0552
Mailing address
1360 BRICKYARD RD, CHIPLEY, FL 32428-6303
(850) 638-1610
(850) 638-0662
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/26/2024
Last updated
12/26/2024
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