Provider Demographics
NPI:1003837899
Name:PEEL, MICHAEL JON (ARNP)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JON
Last Name:PEEL
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 BRASWELL RD
Mailing Address - Street 2:
Mailing Address - City:GRAND RIDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32442
Mailing Address - Country:US
Mailing Address - Phone:850-592-5467
Mailing Address - Fax:
Practice Address - Street 1:100 N MAIN ST
Practice Address - Street 2:FLORIDA STATE HOSPITAL
Practice Address - City:CHATTAHOOCHEE
Practice Address - State:FL
Practice Address - Zip Code:32324-1000
Practice Address - Country:US
Practice Address - Phone:850-663-7832
Practice Address - Fax:850-663-7240
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1713612363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily