Healthcare Provider Details

I. General information

NPI: 1275932816
Provider Name (Legal Business Name): YVENA C FEVRY FAMILY NURSE PRACTIT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YVENA C FEVRY

II. Dates (important events)

Enumeration Date: 08/20/2014
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date: 02/22/2026
Reactivation Date: 03/11/2026

III. Provider practice location address

1817 S UNIVERSITY DR
DAVIE FL
33324-5805
US

IV. Provider business mailing address

1817 S UNIVERSITY DR
DAVIE FL
33324-5805
US

V. Phone/Fax

Practice location:
  • Phone: 954-274-4285
  • Fax: 772-365-4686
Mailing address:
  • Phone: 954-274-4285
  • Fax: 772-365-4686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9176294
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9176294
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9176294
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: