GRACELAND FAMILY PRACTICE NPI 1881293587

NPI Information

NPI: 1881293587
Provider Name: GRACELAND FAMILY PRACTICE
Classification: Clinic/Center - 261QP2300X
Specialization: Primary Care
Entity Type: Organization
Address: 6470 TIPPIN AVE
PENSACOLA, FL
ZIP 32504
Phone: (850) 741-2878

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NPI Details

GRACELAND FAMILY PRACTICE is a primary care clinic center in Pensacola, FL. GRACELAND FAMILY PRACTICE NPI is 1881293587. The provider is registered as an organization entity type.

The provider's business location address is:

6470 TIPPIN AVE
PENSACOLA, FL
ZIP 32504-143
Phone: (850) 741-2878

The provider's authorized official is Debra Ann Fickling .
The authorized official title is Provider and has the following contact phone number (850) 741-2878.

The enumeration date for this NPI number is 10/22/2020 and was last updated on 10/22/2020.

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
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1184196669	MEDICAID	FLORIDA

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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