Doctor Name: | JANE A PRATT |
NPI Number: | 1417931585 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 219 Crewilla Dr Nw Fort Walton Beach, FL - 325483947 |
Business Phone Number: | 8505817700 |
Business Fax Number: | 8502445342 |
Mailing Address: | 219 Crewilla Dr Nw, FORT WALTON BEACH |
State: | FL |
Postal Code: | 325483947 |
Phone Number: | 8505817700 |
Fax Number: | 8502445342 |
NPI Enumeration Date: | 12/02/2005 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |