Tara Nicole Kidd, | |
907 Mar Walt Dr Ste 2013, Fort Walton Beach, FL 32547-6756 | |
(817) 354-5200 | |
(773) 492-8765 |
Full Name | Tara Nicole Kidd |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 907 Mar Walt Dr Ste 2013, Fort Walton Beach, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1285341826 | NPI | - | NPPES |
Entity Name | Bluewater Behavioral Health, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922562628 PECOS PAC ID: 3274873435 Enrollment ID: O20190326000623 |
Mailing Address | Practice Location Address |
---|---|
Tara Nicole Kidd, 4400 E Highway 20 Ste 2013, Niceville, FL 32578-8779 Ph: (850) 797-2598 | Tara Nicole Kidd, 907 Mar Walt Dr Ste 2013, Fort Walton Beach, FL 32547-6756 Ph: (817) 354-5200 |
Celeste Ann Macdonald, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 Phone: 850-431-6183 Fax: 850-431-6497 | |
Brittany Nicole Grimes, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-863-8100 Fax: 850-243-0594 | |
Sylvia Wages, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 Phone: 850-226-6801 Fax: 877-413-5104 | |
Robert Nicholas Donofrio, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 137 Hospital Dr Ne, Fort Walton Beach, FL 32548 Phone: 850-833-7451 Fax: 850-833-7439 | |
Emily Herman, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 319 Green Acres Rd Ste 103, Fort Walton Beach, FL 32547 Phone: 850-862-2385 | |
Julie Clausen Powell, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1005 Mar Walt Drive, Cvs Minute Clinic, Fort Walton Beach, FL 32547 Phone: 850-863-8219 Fax: 850-863-8249 | |
Anne Marie Crow, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1005 Mar Walt Drive, Pulmonology Department, Fort Walton Beach, FL 32547 Phone: 850-243-0118 Fax: 850-243-0594 |