Healthcare Provider Details

I. General information

NPI: 1073409603
Provider Name (Legal Business Name): KEVIN BIRCHFIELD PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 CORKSCREW PALMS CIR STE 300
ESTERO FL
33928-6628
US

IV. Provider business mailing address

9401 CORKSCREW PALMS CIR STE 300
ESTERO FL
33928-6628
US

V. Phone/Fax

Practice location:
  • Phone: 239-676-0601
  • Fax:
Mailing address:
  • Phone: 239-676-0601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11040845
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: