MEDICARE: ARTHUR EDWARD BROUSE APRN

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	11004635	FL

General Provider Information

NPI Number	:	1598308876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARTHUR EDWARD BROUSE APRN

Provider Business Mailing Address
First Line	:	389 PALM COAST PKWY SW UNIT 4
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32137-4772
Country	:	US
Telephone Number	:	386-346-1188
Fax Number	:

Provider Business Practice Location Address
First Line	:	389 PALM COAST PKWY SW UNIT 4
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32137-4772
Country	:	US
Telephone Number	:	386-346-1181
Fax Number	:

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

Provider Enumeration Date	:	10/19/2019
Last Update Date	:	04/07/2026

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