MEDICARE: KATHY VALERIE VERDES ARNP

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	363LP2300X	Primary Care Nurse Practitioner	ARNP9366351	FL

General Provider Information

NPI Number	:	1306360656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY VALERIE VERDES ARNP

Provider Business Mailing Address
First Line	:	3700 GOLDEN GATE BLVD W
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34120-3043
Country	:	US
Telephone Number	:	239-601-4659
Fax Number	:

Provider Business Practice Location Address
First Line	:	7385 RADIO RD STE 104
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34104-6705
Country	:	US
Telephone Number	:	239-384-9392
Fax Number	:	239-294-7252

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2017
Last Update Date	:	09/02/2022

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