Provider Demographics
NPI:1760007991
Name:BEUGRE, PETRINA J (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:PETRINA
Middle Name:J
Last Name:BEUGRE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 AUDACE AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-3500
Mailing Address - Country:US
Mailing Address - Phone:800-341-0119
Mailing Address - Fax:925-237-5886
Practice Address - Street 1:1110 AUDACE AVE,
Practice Address - Street 2:UNIT NBR 303
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-3342
Practice Address - Country:US
Practice Address - Phone:800-341-0119
Practice Address - Fax:561-423-2392
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-12
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9563107364SI0800X
CA95025930163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No364SI0800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistInformatics