MENDING HEARTS PRIMARY CARE LLC NPI 1245008333

NPI Information

  • NPI: 1245008333
  • Provider Name: MENDING HEARTS PRIMARY CARE LLC
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 10D2301571
  • Address: 7901 4TH ST N STE 8298
    ST PETERSBURG, FL
    ZIP 33702
  • Phone: (570) 236-2111

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NPI Details

MENDING HEARTS PRIMARY CARE LLC is a primary care nurse practitioner in St Petersburg, FL. MENDING HEARTS PRIMARY CARE LLC NPI is 1245008333. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7901 4TH ST N STE 8298
ST PETERSBURG, FL
ZIP 33702-305
Phone: (570) 236-2111

The provider's authorized official is Stephanie Bailey .
The authorized official title is Owner and has the following contact phone number (570) 236-2113.

The CLIA number assigned to this NPI record is 10D2301571 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/18/2023 and was last updated on 12/18/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP2300XNurse PractitionerPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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