Provider Demographics
NPI:1699945170
Name:WOMEN & CHILDREN FIRST, LLC
Entity type:Organization
Organization Name:WOMEN & CHILDREN FIRST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:JENNIFER
Authorized Official - Last Name:ESSES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-267-2292
Mailing Address - Street 1:31 E MACK BAYOU DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-7102
Mailing Address - Country:US
Mailing Address - Phone:850-267-2292
Mailing Address - Fax:850-267-3957
Practice Address - Street 1:31 E MACK BAYOU DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-7102
Practice Address - Country:US
Practice Address - Phone:850-267-2292
Practice Address - Fax:850-267-3957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81353174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262645400Medicaid
FL38406OtherMEDICARE ID