Healthcare Provider Details

I. General information

NPI: 1134664220
Provider Name (Legal Business Name): NP INTEGRATIVE HEALTH CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2016
Last Update Date: 11/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13045 MJ RD
MYAKKA CITY FL
34251-5982
US

IV. Provider business mailing address

PO BOX 621
MYAKKA CITY FL
34251-0621
US

V. Phone/Fax

Practice location:
  • Phone: 860-995-0458
  • Fax: 941-761-5696
Mailing address:
  • Phone: 860-995-0458
  • Fax: 941-761-5696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9403992
License Number StateFL

VIII. Authorized Official

Name: MS. ALICIA BEEBE
Title or Position: OWNER
Credential: ARNP, ANP-BC
Phone: 860-995-0458