Practitioner Services, Inc

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

ARNP9189169 Issued in FL

Legal business name

PRACTITIONER SERVICES, INC

Practice address

8931 Falcon Pointe Loop
Fort Myers, FL 33912-1474

Phone

(239) 878-1294

Fax

(239) 468-5878

NPI assigned

May 31, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melissa Ann Grubbs, ARNP

Title

Ceo

Phone

(239) 878-1294

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144421462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8931 FALCON POINTE LOOP",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121474",
            "telephone_number": "239-878-1294",
            "fax_number": "239-468-5878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8931 FALCON POINTE LOOP",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121474",
            "telephone_number": "239-878-1294",
            "fax_number": "239-468-5878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRACTITIONER SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRUBBS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "239-878-1294",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP9189169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zackrey Powers
• Melody Ann Poznanski
• Balachandran Prabakaran, M.D.
• Vani Bhatnagar Prabakaran, D.D.S.
• Punam Prabhakar, M.D.
• Raju Pradhan, MD
• Jessica Prado Rivas
• Giselle Prado-Wright, MD
• Glendy Prado
• Venkat L Prasad, M.D.MBA/MHA

• Gerontology Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.