Beardsley, Bruce Brian

Beardsley, Bruce Brian is an individual health care provider with primary practice located at 12058 San Jose Blvd Ste 1003, Jacksonville FL 32223-8667. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Beardsley, Bruce Brian can be contacted via phone (904) 321-9875.

Contact Information

Primary practice address
12058 San Jose Blvd Ste 1003 Jacksonville FL 32223-8667
Phone: (904) 321-9875
Fax: (904) 321-9890
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X ARNP9273193 Florida
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 9273193 Florida

Profile Details

NPI number 1184071730
LBN Legal business name Beardsley, Bruce Brian
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2016
Last updated Apr 30th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184071730 NPPES
Florida MEDICAID 108369900

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