MR. BRIAN WADE PULLAM (NPI# 1770121535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770121535 |
| Entity Type | Individual |
| Full Name | MR. BRIAN WADE PULLAM |
| Other Name | MR. BRIAN PULLAM |
| Practice Address |
4451 Bayou Blvd Pensacola FL 32503-2601 |
| Mailing Address |
4205 Belfort Rd Ste 41015 Jacksonville FL 32216-1471 |
| Practice Telephone | 8504167619 |
| Practice Fax Number | 8504167753 |
| Mailing Telephone | 9044506014 |
| Mailing Fax Number | 9044506401 |
| Enumeration Date | 2019-12-11 |
| Last Update Date | 2020-05-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
11005354 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 137 Hospital Dr Ne, Fort Walton Beach, FL 325485063 | 8508337500 |
| Street Address |
4451 BAYOU BLVD |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32503-2601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821099839 | Martha H Sanford | Internal Medicine | 4451 Bayou Blvd, Pensacola, FL 32503-2601 | 2005-08-02 |
| 1356903215 | Noelle J Emmons | Nurse Practitioner | 4451 Bayou Blvd, Pensacola, FL 32503-2601 | 2019-07-01 |
| 1750940268 | Lauren Mary Myers | Nurse Practitioner | 4451 Bayou Blvd, Pensacola, FL 32503-2601 | 2019-06-08 |
| 1588222814 | Itumeleng M Ncube | Nurse Practitioner | 4451 Bayou Blvd, Pensacola, FL 32503-2601 | 2019-06-01 |
| 1861980724 | Clorinda M Baker | Nurse Practitioner | 4451 Bayou Blvd, Pensacola, FL 32503-2601 | 2018-04-26 |
| 1649786179 | Ashley Renee Norwood | Nurse Practitioner | 4451 Bayou Blvd, Pensacola, FL 32503-2601 | 2017-12-20 |
| 1164931242 | Abigail Kathryn Fleischman | Nurse Practitioner | 4451 Bayou Blvd, Pensacola, FL 32503-2601 | 2017-09-21 |
| 1215383542 | Michael Trent Norman | Hospitalist | 4451 Bayou Blvd, Pensacola, FL 32503 | 2016-05-05 |
| 1689083354 | Joseph B. Smith Jr. | Speech-Language Pathologist | 4451 Bayou Blvd, Pensacola, FL 32503-2601 | 2014-08-07 |
| 1770994451 | Holly Jay Day | Nurse Practitioner | 4451 Bayou Blvd, Pensacola, FL 32503-2601 | 2014-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134727472 | Lauren Barrett Evans | Nurse Practitioner | 4700 Bayou Boulevard, Suite 6, Pensacola, FL 32503 | 2020-10-09 |
| 1528666864 | Kelsey Christine Kvartek | Nurse Practitioner | 4700 Bayou Blvd., Suite 6, Pensacola, FL 32503 | 2020-10-09 |
| 1730790551 | Sacred Heart Hospital of Pensacola | Podiatrist | 1890 Summit Blvd, Pensacola, FL 32503 | 2020-08-14 |
| 1891312815 | Sacred Heart Asc, LLC | Clinic/Center | 1890 Summit Boulevard, Suite 210, Pensacola, FL 32503 | 2020-06-26 |
| 1275011744 | Teresa T Jansen | Registered Nurse | 5051 Carpenters Creek Dr, Pensacola, FL 32503 | 2018-08-06 |
| 1639662729 | Florida Physical Therapy Services of Pensacola, LLC | Occupational Therapist | 428 Airport Blvd, Pensacola, FL 32503 | 2018-06-13 |
| 1922595123 | Touch of Love Home Health Care LLC | Home Health | 139 E Burgess Rd Ste B, Pensacola, FL 32503 | 2018-04-13 |
| 1770012106 | Amber Mcclellan | Occupational Therapist | 4551 North Davis Highway, Suite C, Pensacola, FL 32503 | 2017-06-08 |
| 1780123885 | Corinne Georgette-marie Carlson | Registered Nurse | 6809 White Oak Drive, Pensacola, FL 32503 | 2017-02-22 |
| 1538615232 | Kristin E Patton | Dietitian, Registered | 4501 North Davis Hwy, Suite C, Pensacola, FL 32503 | 2016-09-01 |
| Find all providers in zip 32503 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121156 | Evangeline Mahima Standridge | Nurse Practitioner | 7828 Woodpointe Dr, Pensacola, FL 32514-6625 | 2020-10-13 |
| 1902411143 | Richard Hutson | Nurse Practitioner | 3660 Cherry Laurel Dr, Pensacola, FL 32504-7519 | 2020-09-14 |
| 1982218202 | Sherri Louise Pucillo | Nurse Practitioner | 1717 N E St Ste 526, Pensacola, FL 32501-6333 | 2020-09-03 |
| 1740893841 | Krista Ivana Robinson | Nurse Practitioner | 5995 Arch Ave, Pensacola, FL 32526-3232 | 2020-08-28 |
| 1578173670 | Lalita Combs | Nurse Practitioner | 6013 Patch Ln, Pensacola, FL 32526-9177 | 2020-08-04 |
| 1053929075 | Cynthia Elaine Garay | Nurse Practitioner | 4270 Langley Ave, Pensacola, FL 32504-8454 | 2020-07-15 |
| 1083254742 | Brittany Beasley Perez | Nurse Practitioner | 543a Fontaine St Ste A, Pensacola, FL 32503-2018 | 2020-01-10 |
| 1912540238 | Jeanne Clack Harris | Nurse Practitioner | 3002 E Jackson St, Pensacola, FL 32503-6437 | 2019-10-18 |
| 1598315608 | Lanora Glaze | Nurse Practitioner | 1645 Elmhurst Rd, Pensacola, FL 32505-1039 | 2019-09-19 |
| 1710547609 | Stephanie Evans | Nurse Practitioner | 6202 N 9th Ave Ste 1a, Pensacola, FL 32504-8291 | 2019-06-13 |
| Find all providers in PENSACOLA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.