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General NPI Number Information
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NPI Number | 1083302004
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Entity Type | Individual
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Provider Name | ALI MICHELLE EVERETT APRN
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Gender | Female
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Dates
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Enumeration Date | 04/27/2023
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 2020 59TH ST W
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City | BRADENTON
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State | FL
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Zip | 34209-4604
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Country | US
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Telephone | 941-752-2837
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Fax |
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Provider Business Mailing Address
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Address Line | 3634 YORK DR W
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City | BRADENTON
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State | FL
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Zip | 34205-2857
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Country | US
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Telephone | 941-518-0874
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11026015
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN11026015
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License Number State | FL
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