Provider Demographics
NPI:1780688341
Name:LARKINS, ELAINE A (ARNP)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:A
Last Name:LARKINS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 REMINGTON GREEN CIR STE 2
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-1550
Mailing Address - Country:US
Mailing Address - Phone:850-385-4494
Mailing Address - Fax:
Practice Address - Street 1:1249 STRONG ROAD
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32353
Practice Address - Country:US
Practice Address - Phone:850-875-9500
Practice Address - Fax:850-627-2786
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2540652363L00000X
FLAPRN2540652363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE2286AOtherMEDICARE PTAN
FL034712400Medicaid
FLE2286AOtherMEDICARE PTAN
FL034712400Medicaid