Provider Demographics
NPI:1265631113
Name:BEVAN, JAMIE M (APRN)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:M
Last Name:BEVAN
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:M
Other - Last Name:BURGESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:235 APOLLO BEACH BLVD # 229
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-2251
Mailing Address - Country:US
Mailing Address - Phone:813-528-3434
Mailing Address - Fax:813-762-1746
Practice Address - Street 1:235 APOLLO BEACH BLVD # 229
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-2251
Practice Address - Country:US
Practice Address - Phone:813-528-3434
Practice Address - Fax:813-762-1746
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9208190163W00000X
FLARNP9208190363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily