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General NPI Number Information
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NPI Number | 1134803240
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Entity Type | Individual
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Provider Name | JAMES WENDELL PREVATT APRN
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Gender | Male
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Dates
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Enumeration Date | 06/12/2023
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 1507 LAKELAND HILLS BLVD
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City | LAKELAND
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State | FL
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Zip | 33805-3205
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Country | US
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Telephone | 813-333-1186
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Fax | 844-691-5928
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Provider Business Mailing Address
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Address Line | 2590 HEALING WAY STE 310
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City | WESLEY CHAPEL
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State | FL
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Zip | 33543-5497
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Country | US
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Telephone | 813-333-1186
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Fax | 844-691-5928
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9546404
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11030621
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11030621
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License Number State | FL
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