Provider Demographics
NPI:1164400255
Name:FALCON, ARLENA C (ARNP-C)
Entity Type:Individual
Prefix:MS
First Name:ARLENA
Middle Name:C
Last Name:FALCON
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5258 NW CANDY LN
Mailing Address - Street 2:
Mailing Address - City:ALTHA
Mailing Address - State:FL
Mailing Address - Zip Code:32421-4452
Mailing Address - Country:US
Mailing Address - Phone:850-663-7501
Mailing Address - Fax:
Practice Address - Street 1:4319 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-2982
Practice Address - Country:US
Practice Address - Phone:850-372-4454
Practice Address - Fax:850-372-4453
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP665682363LA2200X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL34512100Medicaid
FL34512100Medicaid
FLS15328Medicare UPIN