Healthcare Provider Details

I. General information

NPI: 1508966979
Provider Name (Legal Business Name): PATRICIA ANN KEARNS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7305 N MILITARY TRAIL
WEST PALM BEACH FL
33410
US

IV. Provider business mailing address

6924 W CAMINO REAL UNIT 127
BOCA RATON FL
33433
US

V. Phone/Fax

Practice location:
  • Phone: 561-422-6568
  • Fax: 561-422-6992
Mailing address:
  • Phone: 561-347-1408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN2017872
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: