Provider Demographics
NPI:1225613755
Name:JOSEPHS, JOLEE MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:JOLEE
Middle Name:MARIE
Last Name:JOSEPHS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JOLEE
Other - Middle Name:MARIE
Other - Last Name:MOREHEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 11037
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32524-1037
Mailing Address - Country:US
Mailing Address - Phone:850-444-4700
Mailing Address - Fax:850-444-7497
Practice Address - Street 1:1619 CREIGHTON RD STE 1
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-7152
Practice Address - Country:US
Practice Address - Phone:850-444-4700
Practice Address - Fax:850-444-7497
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011903363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110094900Medicaid