| NPI | 1801754726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA NICOLE KIDD Psychiatric Nurse Practitioner 850-204-7201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2026-01-10 |
| Last Update Date | 2026-02-12 |