Beverly Brown, ARNP
Individual provider Active NPI Nurse Practitioner · Bartow, FL
NPI 1316933229 · NPPES record last updated Apr 30, 2008
Key facts
- NPI
- 1316933229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- ARNP1176052 (FL)
- Practice address
- 1255 Golfview Ave
Bartow, FL 33830-6736 - Phone
- (863) 519-3750
- Fax
- (863) 534-7028
- NPI assigned
- Sep 26, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP1176052 | FL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Department of Health | Past | Accepting new patients | |
| Florida Department of Health | Past |
Accepting new patients |
Interoperability endpoints
- beverly.brown.1@26688.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP1176052 | FL | Yes |
Addresses
Primary practice location
1255 Golfview Ave
Bartow, FL 33830-6736
Mailing address
PO Box 1559
Bartow, FL 33831-1559
Phone (863) 519-0575
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 765233000 | Medicaid | FL |
Other providers in Bartow, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.