Brianne Ward
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Mims, FL
NPI 1760112494 · NPPES record last updated Jun 15, 2022
Key facts
- NPI
- 1760112494
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 11020208 (FL)
- Practice address
- 3755 Kloss St
Mims, FL 32754-4941 - Phone
- (321) 544-7856
- NPI assigned
- Jun 15, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11020208 | FL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Refresh Health NP | Psychiatric/Mental Health | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 11020208 | FL | Yes |
Addresses
Primary practice location
3755 Kloss St
Mims, FL 32754-4941
Mailing address
3755 Kloss St
Mims, FL 32754-4941
Phone (321) 544-7856
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Luminello |
Other providers in Mims, FL
- Brenda Lee Stack
- Jennifer Taylor
- Barbara Thorne
- Joseph Tobia
- Walgreen Co.
- Edna Watkins
- Rosalie Rita Zwir-Vitiello
All providers in Mims, FL · Psychiatric/Mental Health Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2022. 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.