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NPI Code Detail

MEDICARE: AVERI BROOKELYN SMITH BOTTS FNP-C

MEDICARE:   AVERI BROOKELYN SMITH BOTTS  FNP-C
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
1363LF0000XFamily Nurse Practitioner35813TN
2363LF0000XFamily Nurse Practitioner89068NM
3363LF0000XFamily Nurse PractitionerARNP.AP.70119731-NPWA
4363LF0000XFamily Nurse Practitioner0024197212VA
5363LF0000XFamily Nurse PractitionerA190777IA
6363LF0000XFamily Nurse PractitionerC-APN.0106500-C-NPCO
7363LF0000XFamily Nurse PractitionerLG-0013906DE
8363LF0000XFamily Nurse Practitioner0041958OH
9363LF0000XFamily Nurse Practitioner3-000030AL
10363LF0000XFamily Nurse Practitioner116847NE
11363LF0000XFamily Nurse Practitioner227891AR
12363LF0000XFamily Nurse Practitioner903103MS

General Provider Information

NPI Number : 1992323059
Entity Type Code : Individual
Provider Name (Legal Business Name) : AVERI BROOKELYN SMITH BOTTS FNP-C
Provider Business Mailing Address
First Line : 1105 OAK ST
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-8921
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 232 MARKET ST
Second Line :
City : FLOWOOD
State : MS
Zip : 39232-3339
Country : US
Telephone Number : 866-849-0692
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2020
Last Update Date : 05/28/2026

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Directions to “ AVERI BROOKELYN SMITH BOTTS FNP-C” Practice Location

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