PRISCILLA CHRISTINE PHAN (NPI# 1578098695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578098695 |
| Entity Type | Individual |
| Full Name | PRISCILLA CHRISTINE PHAN |
| Credential | PA-C |
| Practice Address |
1619 Creighton Rd Suite 1 Pensacola FL 32504-7152 |
| Practice Telephone | 8504444700 |
| Practice Fax Number | 8504348144 |
| Mailing Telephone | (850) 444-4700 |
| Mailing Fax Number | 8504447497 |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9110351 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9110351 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 020947500 | 05 | |
| FL | FLORIDA STATE DOH MEDICAL LICENSURE | PA9110351 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 14114 Alabama St, Jay, FL 325651219 | 8504444700 | 8504348144 |
| 1118 Gulf Breeze Pkwy Ste 200, Gulf Breeze, FL 325617806 | 8504444700 | 8504348144 |
| 319 Green Acres Rd Ste 103, Fort Walton Beach, FL 325471170 | 8508622385 | 8508620482 |
| 4415 Us Highway 331 S, Defuniak Springs, FL 324356307 | 8503986606 | 8503986424 |
| 221 E Redstone Ave, Crestview, FL 325395373 | 8503986606 | 8503986424 |
| 6001 Industrial Blvd, Century, FL 325353312 | 8504444700 | 8504348144 |
| 1717 N E St Ste 403, Pensacola, FL 325016334 | 8504444700 | 8504348144 |
| 2940 N Blue Angel Pkwy, Pensacola, FL 325062925 | 8504444700 | 8504348144 |
| 5149 N 9th Ave Ste G35, Pensacola, FL 325048733 | 8504444700 | 8504348144 |
| 5934 Berryhill Medical Park Dr # 1, Milton, FL 32570 | 8506234771 | 8506233938 |
| 8880 Navarre Pkwy Ste 101, Navarre, FL 325663613 | 8508622385 | 8508620482 |
| 4304 Lancaster Dr, Niceville, FL 325784563 | 8508622385 | 8508620482 |
| 4583 Watkins St, Pace, FL 325712511 | 8508894152 | 8506233938 |
| 36474a Emerald Coast Pkwy Ste 1102, Destin, FL 325413706 | 8508622385 | 8508620482 |
| Street Address |
1619 CREIGHTON RD SUITE 1 |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32504-7152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376545566 | Humam Humeda | Internal Medicine | 1619 Creighton Rd, Ste 1, Pensacola, FL 32504-7152 | 2005-06-01 |
| 1720621774 | Aubri Rihan Velez | Rehabilitation Practitioner | 1619 Creighton Rd, Pensacola, FL 32504-7152 | 2019-10-22 |
| 1992361372 | Danielle Smyly | Nurse Practitioner | 1619 Creighton Rd, Pensacola, FL 32504-7152 | 2019-05-11 |
| 1881131621 | Fresenius Vascular Care of Pensacola Asc LLC | Clinic/Center | 1619 Creighton Rd, Pensacola, FL 32504-7152 | 2017-01-31 |
| 1023405222 | Nicole Anne Clem | Nurse Practitioner | 1619 Creighton Rd, Suite 1, Pensacola, FL 32504-7152 | 2015-04-25 |
| 1285031963 | Fresenius Vascular Care Pensacola LLC | Radiology | 1619 Creighton Rd, Pensacola, FL 32504-7152 | 2014-11-25 |
| 1598199804 | Erin Elizabeth Luescher | Physician Assistant | 1619 Creighton Rd, Pensacola, FL 32504-7152 | 2013-08-23 |
| 1417296401 | Cindy Kathleen Lawrence | Nurse Practitioner | 1619 Creighton Rd, Pensacola, FL 32504-7152 | 2013-02-11 |
| 1841265253 | Haitham O Qader | Internal Medicine | 1619 Creighton Rd, Suite 1, Pensacola, FL 32504-7152 | 2006-02-20 |
| 1285636472 | Ronnie D Wiles | Internal Medicine | 1619 Creighton Rd, Suite 1, Pensacola, FL 32504-7152 | 2005-06-01 |
| Find all providers in the same location | ||||
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|---|---|---|---|---|
| 1659978393 | Quinyatta Stride | Behavior Technician | 2511 Creighton Rd., Pensacola, FL 32504 | 2020-10-06 |
| 1962017657 | Pt Solutions of Pensacola LLC | Occupational Therapist | 2114 Creighton Rd, Ste C, Pensacola, FL 32504 | 2020-09-10 |
| 1982226742 | Elevate Behavioral Solutions | Behavioral Analyst | 4045 Renoir St, Pensacola, FL 32504 | 2020-05-14 |
| 1760021349 | Veteran Evaluations of Florida | Internal Medicine | 2411 Executive Plaza Drive, Suite A, Pensacola, FL 32504 | 2019-12-31 |
| 1215575527 | First City Health LLC | Pharmacy | 6005 College Parkway, Suite 1, Pensacola, FL 32504 | 2019-12-17 |
| 1184261158 | Claire Ann Letendre | Audiologist | 5153 N 9th Ave Pediatric Off Building, Pensacola, FL 32504 | 2019-12-09 |
| 1083275101 | Benjamin Mcmillon | Chiropractor | 2629 Creighton Road, Suite 1, Pensacola, FL 32504 | 2019-06-28 |
| 1407342595 | Faryal Munir | Student in an Organized Health Care Education/Training Program | Uf Pediatric Residency 5151 North 9th Ave, 6th Floor Nemours, Pensacola, FL 32504 | 2018-07-02 |
| 1497252050 | Sibyl Tenille Page | Nurse Practitioner | 5147 N 9th Ave Ste 322, Pensacola, FL 32504 | 2018-04-10 |
| 1396272589 | Sacred Heart Hospital | General Acute Care Hospital | 2552 Carmel Heights Rd, Pensacola, FL 32504 | 2017-05-18 |
| Find all providers in zip 32504 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518593326 | Shelby Jane Carson | Physician Assistant | 8333 N Davis Hwy Fl 3, Pensacola, FL 32514-6050 | 2020-03-13 |
| 1477194934 | Alyssa Brooke Mayer | Physician Assistant | 4501 N Davis Hwy Ste A, Pensacola, FL 32503-2724 | 2019-10-04 |
| 1720638448 | Frances Ponsuwan Bell | Physician Assistant | 5151 N 9th Ave # 200, Pensacola, FL 32504-8721 | 2019-09-14 |
| 1881242022 | Kendall Hoover | Physician Assistant | 190 E Intendencia St # A-28, Pensacola, FL 32502-5806 | 2019-08-30 |
| 1477047181 | Taylor Elaine Morrison | Physician Assistant | 4901 Marketplace Road, Pensacola, FL 32504-8986 | 2018-06-15 |
| 1245771591 | Tina Rayfield | Physician Assistant | 12480 Seratine Dr, Pensacola, FL 32506-9601 | 2017-03-19 |
| 1891166344 | Kevin Lacz | Physician Assistant | 100 S Baylen St, Suite A, Pensacola, FL 32502-5825 | 2015-10-09 |
| 1831448653 | Hillary H. Doussan | Physician Assistant | 8333 N. Davis Hwy, Pensacola, FL 32514-6050 | 2012-09-07 |
| 1891004560 | Lauren Andrea Treven | Physician Assistant | 3205 E Olive Rd, Apt 80, Pensacola, FL 32514-7239 | 2010-09-29 |
| 1285948703 | Sarah Grace Purdy | Physician Assistant | 5503 Admiral Doyle Rd, Pensacola, FL 32506-5353 | 2010-07-27 |
| Find all providers in PENSACOLA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.