Healthcare Provider Details

I. General information

NPI: 1942626932
Provider Name (Legal Business Name): BEVERLY ANN BOND ARNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2014
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101B W HIGHWAY 98
PANAMA CITY FL
32401-1251
US

IV. Provider business mailing address

3101B W HIGHWAY 98
PANAMA CITY FL
32401-1251
US

V. Phone/Fax

Practice location:
  • Phone: 850-763-0446
  • Fax: 850-763-7787
Mailing address:
  • Phone: 850-763-0446
  • Fax: 850-763-7787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberARNP 1263792
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: