Provider Demographics
NPI:1285642488
Name:MIGHTY, EVAN ARLENE (ARNP, CNM)
Entity Type:Individual
Prefix:MS
First Name:EVAN
Middle Name:ARLENE
Last Name:MIGHTY
Suffix:
Gender:F
Credentials:ARNP, CNM
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Other - First Name:
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Mailing Address - Street 1:2401 FRIST BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4839
Mailing Address - Country:US
Mailing Address - Phone:772-429-3400
Mailing Address - Fax:772-429-3410
Practice Address - Street 1:2401 FRIST BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4839
Practice Address - Country:US
Practice Address - Phone:772-429-3400
Practice Address - Fax:772-429-3410
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9231838363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner