Basic Information
Provider Information
NPI: 1902138647
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMSEY
FirstName: JENNIFER
MiddleName: GEORGE
NamePrefix: MRS.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: GEORGE
OtherFirstName: JENNIFER
OtherMiddleName: KATHERINE
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 2699
Address2:  
City: PENSACOLA
State: FL
PostalCode: 325132699
CountryCode: US
TelephoneNumber:  
FaxNumber: 8504754619
Practice Location
Address1: 1549 AIRPORT BLVD
Address2: SUITE 2000
City: PENSACOLA
State: FL
PostalCode: 325048633
CountryCode: US
TelephoneNumber: 8504166933
FaxNumber: 8504166934
Other Information
ProviderEnumerationDate: 02/05/2010
LastUpdateDate: 08/15/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X  Y Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


Home