Provider Demographics
NPI:1700051802
Name:F & G PROFESSIONAL CARE COORDINATORS LLC
Entity Type:Organization
Organization Name:F & G PROFESSIONAL CARE COORDINATORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER F & G PROFESSIONAL CARE
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:FANCY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:850-212-4448
Mailing Address - Street 1:2910 KERRY FOREST PARKWAY
Mailing Address - Street 2:D4-188
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309
Mailing Address - Country:US
Mailing Address - Phone:850-212-4448
Mailing Address - Fax:850-893-4182
Practice Address - Street 1:3458 PACES FERRY RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309
Practice Address - Country:US
Practice Address - Phone:850-212-4448
Practice Address - Fax:850-893-4182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN3192112163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty