IndividualActive
Stephanie Lilly, PMHNP-BC, FNP-BC
NPI 1194200147 · Family Nurse Practitioner · Fort Walton Beach, FL
Provider details
- NPI number
- 1194200147
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PMHNP-BC, FNP-BC
- Sex
- Female
- Sole proprietor
- No
- License
- APRN79287-FNP-BC (WV)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1702 Conservation Trl Unit 104
Fort Walton Beach, FL 32547-5087
Phone: (304) 731-5195
Fax: (202) 951-6439
Street-level locationGet directions
Mailing address
1702 Conservation Trl Unit 104
Fort Walton Beach, FL 32547-5087
Registry dates
- Enumerated
- 2018-09-26
- Last updated
- 2024-03-06
- Certified
- 2024-02-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.