| Brantley Health And Wellness Llc | |
|
489 N Tyndall Pkwy Panama City FL 32404-6126 | |
| (850) 866-7711 | |
| (850) 387-2776 |
| Full Name | Brantley Health And Wellness Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 489 N Tyndall Pkwy, Panama City, Florida |
| Authorized Official Name and Position | Nicholas J Brantley (PROVIDER/OWNER) |
| Authorized Official Contact | 7278048193 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brantley Health And Wellness Llc 5524 Mars Hill Ln Panama City FL 32404-4327 Ph: (850) 896-2742 | Brantley Health And Wellness Llc 489 N Tyndall Pkwy Panama City FL 32404-6126 Ph: (850) 866-7711 |
| NPI Number | 1861220626 |
|---|---|
| Provider Enumeration Date | 07/23/2024 |
| Last Update Date | 01/29/2025 |
| Medicare PECOS PAC ID | 2961940127 |
|---|---|
| Medicare Enrollment ID | O20240819003405 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861220626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Nicholas J Brantley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942891569 PECOS PAC ID: 2769874460 Enrollment ID: I20220615000568 |
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