Provider Demographics
NPI:1306360656
Name:VERDES, KATHY VALERIE (ARNP)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:VALERIE
Last Name:VERDES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 GOLDEN GATE BLVD W
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-3043
Mailing Address - Country:US
Mailing Address - Phone:239-601-4659
Mailing Address - Fax:
Practice Address - Street 1:7385 RADIO RD STE 104
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-6705
Practice Address - Country:US
Practice Address - Phone:239-384-9392
Practice Address - Fax:239-294-7252
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9366351363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care