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General NPI Number Information
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NPI Number | 1952724726
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Entity Type | Individual
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Provider Name | MARIE RACHEL PREVILUS DNP, ARNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/29/2014
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 701 PARK AVE
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City | LAKE PARK
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State | FL
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Zip | 33403-2503
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Country | US
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Telephone | 561-301-8675
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Fax | 561-301-8675
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Provider Business Mailing Address
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Address Line | 701 PARK AVE
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City | LAKE PARK
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State | FL
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Zip | 33403-2503
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Country | US
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Telephone | 561-301-8675
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Fax | 949-703-7886
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP3345292
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License Number State | FL
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