Provider Demographics
NPI:1497175921
Name:HOWARD, BEVERLEY YVETTE
Entity Type:Individual
Prefix:MS
First Name:BEVERLEY
Middle Name:YVETTE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BEVERLEY
Other - Middle Name:YVETTE
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP
Mailing Address - Street 1:2920 FLORA RIDGE CIR APT 229
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7588
Mailing Address - Country:US
Mailing Address - Phone:407-697-6177
Mailing Address - Fax:
Practice Address - Street 1:200 PARK PLACE BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-2344
Practice Address - Country:US
Practice Address - Phone:407-846-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2023-09-23
Deactivation Date:2023-03-07
Deactivation Code:
Reactivation Date:2023-03-14
Provider Licenses
StateLicense IDTaxonomies
FL3003062363LP0808X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health