Organization
NORTH OKALOOSA CLINIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA MUSIC (DIRECTOR, PROVIDER ENROLLMENT)
(877) 892-9815
Entity
Organization
Contact information
Practice address
400 REDSTONE AVE W, CRESTVIEW, FL 32536-8467
(850) 683-1555
(850) 683-1556
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7269
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
208600000X
Surgery Physician
Primary
—
—
208800000X
Urology Physician
—
—
363AS0400X
Surgical Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Enumeration date
10/03/2023
Last updated
07/11/2024
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