Provider Demographics
NPI:1508309006
Name:BESWICK, BRIDGETTE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGETTE
Middle Name:
Last Name:BESWICK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16799 TANGERINE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-3365
Mailing Address - Country:US
Mailing Address - Phone:561-308-3244
Mailing Address - Fax:
Practice Address - Street 1:1700 SE HILLMOOR DR STE 102
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7544
Practice Address - Country:US
Practice Address - Phone:772-777-2993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-01
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9294750363LF0000X
FLARNP9294750363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily