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

Mrs. Stephanie Diane Lilly, PMHNP-BC, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1194200147

Mrs. Stephanie Diane Lilly, PMHNP-BC, FNP-BC is a Nurse Practitioner in Fort Walton Beach, Florida. Qualified in 2018, 8 years ago. Practices with Ppcc, Inc, a 9-clinician group and offers telehealth. Licensed in West Virginia.

Years since qualifying
8
Licensed in
WV
In the registry since
2018
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

1702 Conservation Trl Unit 104
Fort Walton Beach, FL 32547-5087
Phone: (304) 731-5195
Fax: (202) 951-6439
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN79287-FNP-BC (WV)

Record details

NPI number1194200147
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC , FNP-BC
Sole proprietorNo
NPI enumeratedSeptember 26, 2018
Last updated in NPPESMarch 6, 2024
Certification dateFebruary 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Ppcc, Inc. — 9 clinicians
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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