BEVERLY BROADNAX (NPI# 1477969665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477969665 |
| Entity Type | Individual |
| Full Name | BEVERLY BROADNAX |
| Practice Address |
2814 Edwards Ave S Saint Petersburg FL 33705-3653 |
| Practice Telephone | 7276426894 |
| Mailing Telephone | 7276426894 |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2014-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | PN142291 | FL | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 141557300 | 05 |
| Street Address |
2814 EDWARDS AVE S |
| City | SAINT PETERSBURG |
| State | FL |
| Zip Code | 33705-3653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935781 | Caressa Alice Slocum | Psychologist | 840 Dr M.l.k. Jr St N, St. Petersburg, FL 33705 | 2020-09-01 |
| 1386133015 | Angela Ann Little | Social Worker | 920 Country Club Way S, St Petersburg, FL 33705 | 2018-05-08 |
| 1497279483 | Infinity Health Consultants, LLC. | In Home Supportive Care | 1001 27th Avenue South, St. Petersburg, FL 33705 | 2017-08-01 |
| 1801320528 | Dedicated Senior Medical Center St. Petersburg, LLC. | Non-Pharmacy Dispensing Site | 901 22nd Avenue South, Dedicated Senior Medical Center St. Petersburg, LLC., St. Petersburg, FL 33705 | 2017-04-19 |
| 1790135762 | Robin Dong | Emergency Medicine | 1095 5th Ave N, St. Petersburg, FL 33705 | 2016-06-20 |
| 1437550084 | Community Health Center of Pinellas Inc | Clinic/Center | 612 Dr Martin L King St N, St Petersburg, FL 33705 | 2014-09-12 |
| 1164851754 | Jennifer Carey | Counselor | 11 Mlk Jr St South, St. Petersburg, FL 33705 | 2013-11-05 |
| 1750623997 | Dannaly Reyes Baerga | Physical Medicine & Rehabilitation | 1201 5th Ave N Ste 202, St Petersburg, FL 33705 | 2013-03-26 |
| 1518209055 | Nii Sai Torto | Emergency Medicine | 500 Doctor. M.l.k, Jr. Street North, Ste 303, Saint Petersburg, FL 33705 | 2013-03-22 |
| 1790034635 | Melissa White Kidwell | Physical Therapist | 500 Mlking Street N, Ste 100, St. Petersburg, FL 33705 | 2012-09-06 |
| Find all providers in zip 33705 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427674530 | Linda Barnes-bonneau | Licensed Practical Nurse | 4534 13th Ave S, Saint Petersburg, FL 33711-2409 | 2020-06-24 |
| 1538640685 | Southern Oasis Living LLC | Licensed Practical Nurse | 2527 10th Ave S, Saint Petersburg, FL 33712-2021 | 2018-08-27 |
| 1013415330 | Darin Locy | Licensed Practical Nurse | 10840 Poplar St Ne, Saint Petersburg, FL 33716-3308 | 2018-02-01 |
| 1174037089 | Julius Griffin | Licensed Practical Nurse | 1115 Highland St N, Apt B, Saint Petersburg, FL 33701 | 2017-11-30 |
| 1588016505 | Alexis Waters Waters | Licensed Practical Nurse | 630 40th St S, Saint Petersburg, FL 33711-1636 | 2016-07-02 |
| 1386014710 | Heaven Ratleff | Licensed Practical Nurse | 11601 4th St N Apt 1605, Saint Petersburg, FL 33716-2742 | 2015-09-28 |
| 1275892234 | Randy Dale Woodard | Licensed Practical Nurse | 5971 Terrace Park Dr N, Unit 108, Saint Petersburg, FL 33709-1181 | 2012-05-11 |
| 1215199732 | Viengchai Kempienski | Licensed Practical Nurse | 2635 37th Ave N, Saint Petersburg, FL 33713-1731 | 2008-06-26 |
| 1356520274 | Shawn Edward Brooks | Licensed Practical Nurse | 5602 59th Way N, Saint Petersburg, FL 33709-1828 | 2007-10-27 |
| 1164958757 | Clear Path Center Pa | Licensed Practical Nurse | 3177 4th St N, Saint Petersburg, FL 33704-2124 | 2017-05-03 |
| Find all providers in SAINT PETERSBURG | ||||
| City | SAINT PETERSBURG |
| Zip Code | 33705 |
Please comment or provide details below to improve the information on BEVERLY BROADNAX.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.