Provider Demographics
NPI:1285406074
Name:FIRST NATION GROUP, LLC
Entity type:Organization
Organization Name:FIRST NATION GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR TAX & LICENSING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SKOWRONSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-424-6405
Mailing Address - Street 1:4566 E HIGHWAY 20 STE 208
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-8839
Mailing Address - Country:US
Mailing Address - Phone:850-389-8448
Mailing Address - Fax:
Practice Address - Street 1:2537 CRYSTAL DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-8361
Practice Address - Country:US
Practice Address - Phone:239-308-1218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies