MEDICARE: MRS. ULRIKA BRASSART KANG APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	APRN11009972	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598423154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ULRIKA BRASSART KANG APRN

Provider Business Mailing Address
First Line	:	2995 DREW ST FL 2
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-3012
Country	:	US
Telephone Number	:	727-281-9065
Fax Number	:

Provider Business Practice Location Address
First Line	:	6901 SIMMONS LOOP FL MS 80664
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33578-9498
Country	:	US
Telephone Number	:	813-302-8388
Fax Number	:	813-302-8453

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2021
Last Update Date	:	03/10/2026

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