Provider Demographics
NPI:1487634358
Name:JANE A PRATT DBA NEW BEGINNINGS
Entity type:Organization
Organization Name:JANE A PRATT DBA NEW BEGINNINGS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:CFM
Authorized Official - Phone:850-581-7700
Mailing Address - Street 1:219 CREWILLA DR NW
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32548-3947
Mailing Address - Country:US
Mailing Address - Phone:850-581-7700
Mailing Address - Fax:850-244-5342
Practice Address - Street 1:219 CREWILLA DR NW
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32548-3947
Practice Address - Country:US
Practice Address - Phone:850-581-7700
Practice Address - Fax:850-244-5342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL94722OtherBLUE CROSS BLUE SHIELD
22996OtherPRINCIPAL HEALTH
81731OtherNORTHWOOD
FLR9474OtherBCBS
81731OtherNORTHWOOD
4925550001Medicare ID - Type Unspecified