Provider Demographics
NPI:1942901491
Name:CRANFORD, DESIREE BARBARA BEAUCHER (BSN, RN, RNFA, CNOR)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:BARBARA BEAUCHER
Last Name:CRANFORD
Suffix:
Gender:F
Credentials:BSN, RN, RNFA, CNOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10407 SW LANDRY LN
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-2501
Mailing Address - Country:US
Mailing Address - Phone:772-633-9165
Mailing Address - Fax:
Practice Address - Street 1:851 W INDIANTOWN RD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7508
Practice Address - Country:US
Practice Address - Phone:561-747-1232
Practice Address - Fax:561-747-1251
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9510967163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant