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NPI Code Detail

MEDICARE: KERRI BREANNE BEVARD RN

MEDICARE: KERRI BREANNE BEVARD RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN9497439FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN9497439OTHERFLRN LICENSE

General Provider Information

NPI Number : 1023650918
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERRI BREANNE BEVARD RN
Provider Business Mailing Address
First Line : 13601 N 22ND ST
Second Line :
City : TAMPA
State : FL
Zip : 33613-4427
Country : US
Telephone Number : 813-559-4705
Fax Number : 813-804-6236
Provider Business Practice Location Address
First Line : 13601 N 22ND ST
Second Line :
City : TAMPA
State : FL
Zip : 33613-4427
Country : US
Telephone Number : 813-559-4705
Fax Number : 813-804-6236
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2019
Last Update Date : 10/11/2019

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Directions to “ KERRI BREANNE BEVARD RN” Practice Location

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