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General NPI Number Information
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NPI Number | 1306685003
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Entity Type | Organization
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Legal Business Name | ADVANCED PRACTICE SKILLS WORKSHOP LLC
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Dates
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Enumeration Date | 05/22/2024
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 2927 PEARSON JAMES PLACE
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City | LUTZ
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State | FL
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Zip | 33559
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Country | US
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Telephone | 813-428-5295
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 47475
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City | TAMPA
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State | FL
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Zip | 33646-0113
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Country | US
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Telephone | 404-370-2158
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. ERICA R EVANS
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Credential | APRN
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Telephone | 404-370-2158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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