Provider Demographics
NPI:1881432193
Name:BELTRANENA, KALYN COLETA (APRN)
Entity type:Individual
Prefix:
First Name:KALYN
Middle Name:COLETA
Last Name:BELTRANENA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5942 NW WOLVERINE RD
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-3651
Mailing Address - Country:US
Mailing Address - Phone:772-267-3720
Mailing Address - Fax:
Practice Address - Street 1:5942 NW WOLVERINE RD
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-3651
Practice Address - Country:US
Practice Address - Phone:772-267-3720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11034027363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily