Provider Demographics
NPI:1023121852
Name:PLANNED PARENTHOOD OF NORTHEAST FLORIDA, INC.
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF NORTHEAST FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:DESTA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MESSER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:904-399-2800
Mailing Address - Street 1:3850 BEACH BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-4757
Mailing Address - Country:US
Mailing Address - Phone:904-399-2800
Mailing Address - Fax:904-399-2333
Practice Address - Street 1:3850 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-4757
Practice Address - Country:US
Practice Address - Phone:904-399-2800
Practice Address - Fax:904-399-2333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty