Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Emerald Waters Medical Clinic LLC

Organization Nurse Practitioner · NPI 1306192216

Emerald Waters Medical Clinic LLC is a Nurse Practitioner in Niceville, Florida. Licensed in Florida. Registered with an NPI since 2012.

Licensed in
FL
In the registry since
2012
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1005 College Blvd W Ste B
Niceville, FL 32578-1060
Phone: (850) 279-6815
Fax: (850) 279-6817
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence ARNP3114742 (FL)
Primary Care Nurse Practitioner Taxonomy 363LP2300X
Women's Health Nurse Practitioner Taxonomy 363LW0102X · Licence ARNP3114742 (FL)

Record details

NPI number1306192216
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mauricia Stanton — Owner/Provider · (850) 582-6059
NPI enumeratedJuly 28, 2012
Last updated in NPPESAugust 3, 2022
Certification dateAugust 3, 2022
Mailing address1005 College Blvd W, Suite B, Niceville, FL 32578-1060

Other providers in Niceville