Healthcare Provider Details

I. General information

NPI: 1164358008
Provider Name (Legal Business Name): GUERLINE VERGER-COREUS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5647 HOLLYWOOD BLVD
HOLLYWOOD FL
33021-6325
US

IV. Provider business mailing address

5647 HOLLYWOOD BLVD
HOLLYWOOD FL
33021-6325
US

V. Phone/Fax

Practice location:
  • Phone: 954-276-1631
  • Fax:
Mailing address:
  • Phone: 954-276-1631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11048210
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: