| Emilia Banse Pmhnp-bc Pllc | |
|
120 Golden Eagle Ct Santa Rosa Beach FL 32459-8344 | |
| (202) 876-8787 | |
| Not Available |
| Full Name | Emilia Banse Pmhnp-bc Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 Golden Eagle Ct, Santa Rosa Beach, Florida |
| Authorized Official Name and Position | Emilia M Banse (NURSE PRACTITIONER/OWNER) |
| Authorized Official Contact | 2028768787 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emilia Banse Pmhnp-bc Pllc 120 Golden Eagle Ct Santa Rosa Beach FL 32459-8344 Ph: (202) 876-8787 | Emilia Banse Pmhnp-bc Pllc 120 Golden Eagle Ct Santa Rosa Beach FL 32459-8344 Ph: (202) 876-8787 |
| NPI Number | 1164044004 |
|---|---|
| Provider Enumeration Date | 05/14/2020 |
| Last Update Date | 05/14/2020 |
| Certification Date | 05/14/2020 |
| Medicare PECOS PAC ID | 8022430248 |
|---|---|
| Medicare Enrollment ID | O20200617000281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164044004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Emilia M Banse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215278650 PECOS PAC ID: 1456593060 Enrollment ID: I20150225002201 |
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