MEDICARE: NP INTEGRATIVE HEALTH CARE PLLC

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
2	363LA2200X	Adult Health Nurse Practitioner	ARNP9403992	FL

General Provider Information

NPI Number	:	1134664220
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NP INTEGRATIVE HEALTH CARE PLLC

Provider Business Mailing Address
First Line	:	PO BOX 621
Second Line	:
City	:	MYAKKA CITY
State	:	FL
Zip	:	34251-0621
Country	:	US
Telephone Number	:	860-995-0458
Fax Number	:	941-761-5696

Provider Business Practice Location Address
First Line	:	13045 MJ RD
Second Line	:
City	:	MYAKKA CITY
State	:	FL
Zip	:	34251-5982
Country	:	US
Telephone Number	:	860-995-0458
Fax Number	:	941-761-5696

Authorized Official
Title or Position	:	OWNER
Name	:	MS. ALICIA BEEBE
Credential	:	ARNP, ANP-BC
Telephone Number	:	860-995-0458

Provider Enumeration Date	:	12/27/2016
Last Update Date	:	11/25/2019

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