Jeanette A Bevilacqua, ARNP

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

ARNP 920292 Issued in FL

Practice address

8660 College Pkwy
230
Fort Myers, FL 33919-4886

Phone

(239) 433-1403

Fax

(239) 433-5303

NPI assigned

May 13, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1083881684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8660 COLLEGE PKWY",
            "address_2": "230",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194886",
            "telephone_number": "239-433-1403",
            "fax_number": "239-433-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8660 COLLEGE PKWY",
            "address_2": "230",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194886",
            "telephone_number": "239-433-1403",
            "fax_number": "239-433-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVILACQUA",
        "first_name": "JEANETTE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP 920292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Registered Nurse in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Psychiatric/Mental Health Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.