Provider Demographics
NPI:1528585304
Name:BEYER, REBECCA C (ARNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:C
Last Name:BEYER
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 1:2000 NEBRASKA AVE
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4833
Mailing Address - Country:US
Mailing Address - Phone:772-465-4444
Mailing Address - Fax:772-465-4499
Practice Address - Street 1:2000 NEBRASKA AVE
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4833
Practice Address - Country:US
Practice Address - Phone:772-465-4444
Practice Address - Fax:772-465-4499
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9310123363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner