Provider Demographics
NPI:1306452966
Name:MALOY, VELVET C (APRN-C)
Entity type:Individual
Prefix:
First Name:VELVET
Middle Name:C
Last Name:MALOY
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4624 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2353
Mailing Address - Country:US
Mailing Address - Phone:850-494-0000
Mailing Address - Fax:850-494-0001
Practice Address - Street 1:4624 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2353
Practice Address - Country:US
Practice Address - Phone:850-494-0000
Practice Address - Fax:850-494-0001
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010116363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN11010116OtherLICENSE