Provider Demographics
NPI:1275213415
Name:SUNNMEDICAL
Entity Type:Organization
Organization Name:SUNNMEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KATORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:APRN AGPCNP-BC
Authorized Official - Phone:850-345-9522
Mailing Address - Street 1:3354 CAMERON CHASE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-2872
Mailing Address - Country:US
Mailing Address - Phone:850-345-9522
Mailing Address - Fax:
Practice Address - Street 1:118 N MONROE ST STE 310
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-1557
Practice Address - Country:US
Practice Address - Phone:850-755-2063
Practice Address - Fax:850-254-9826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty