Provider Demographics
NPI:1922195809
Name:HUNT, BEVERLY JEAN (ARNP)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:JEAN
Last Name:HUNT
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 1:6650 W INDIANTOWN RD
Mailing Address - Street 2:SUITE #110
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-4628
Mailing Address - Country:US
Mailing Address - Phone:561-575-9876
Mailing Address - Fax:561-575-2858
Practice Address - Street 1:6650 W INDIANTOWN RD
Practice Address - Street 2:SUITE 110
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-4628
Practice Address - Country:US
Practice Address - Phone:561-575-9876
Practice Address - Fax:561-575-2858
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 880892363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305525600Medicaid