Provider Demographics
NPI:1184438731
Name:FOUR PILLARS HEALTHCARE PLLC
Entity type:Organization
Organization Name:FOUR PILLARS HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-BC
Authorized Official - Phone:850-532-8485
Mailing Address - Street 1:272 FOREST PARK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4216
Mailing Address - Country:US
Mailing Address - Phone:850-273-6131
Mailing Address - Fax:850-407-5322
Practice Address - Street 1:272 FOREST PARK CIRCLE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405
Practice Address - Country:US
Practice Address - Phone:850-273-6131
Practice Address - Fax:850-404-5322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty