Provider Demographics
NPI:1770572158
Name:WOMENS HEALTH P A
Entity type:Organization
Organization Name:WOMENS HEALTH P A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:D
Authorized Official - Last Name:STEARNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-476-3696
Mailing Address - Street 1:4900 GRANDE DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8951
Mailing Address - Country:US
Mailing Address - Phone:850-476-3696
Mailing Address - Fax:850-477-3573
Practice Address - Street 1:4900 GRANDE DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8951
Practice Address - Country:US
Practice Address - Phone:850-476-3696
Practice Address - Fax:850-477-3573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DB3473OtherMEDICARE RR
FL33867OtherBCBSFL
FL267946900Medicaid
FL0700389OtherUNITED HEALTHCARE
FL0700389OtherUNITED HEALTHCARE