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BEVERLEY BODLEY

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1659924785

Individual Registrant:
 BEVERLEY  BODLEY 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
5964 US HIGHWAY 90  LIVE OAK, FL 32060-8694 US
Tel: 386-963-6201  Fax: --

Contact information for business:
2051 RAFTON RD  APOPKA, FL 32703-8437 US
Tel: 407-219-1617  Fax: --

Registration Information:
NPI: 1659924785
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
FL11001222

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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