Healthcare Provider Details

I. General information

NPI: 1851654743
Provider Name (Legal Business Name): PATRICIA M TESTA ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2012
Last Update Date: 02/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SE OCEAN BLVD SUITE 100
STUART FL
34996-3332
US

IV. Provider business mailing address

19859 GARDENIA DR
JUPITER FL
33469-2183
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-2115
  • Fax:
Mailing address:
  • Phone: 330-719-2438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberARNP9246061
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: