Provider Demographics
NPI:1295759900
Name:STOREY, MAUREEN A (ARNP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:A
Last Name:STOREY
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 1:4215 BURNS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4625
Mailing Address - Country:US
Mailing Address - Phone:561-694-7776
Mailing Address - Fax:561-694-3099
Practice Address - Street 1:7701 SOUTHERN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-3803
Practice Address - Country:US
Practice Address - Phone:561-694-7776
Practice Address - Fax:561-694-3099
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2020-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1084262363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7001ZMedicare PIN
E7001ZMedicare ID - Type Unspecified
FL304121200Medicaid