Beverly, Laura Nance

Beverly, Laura Nance is an individual health care provider with primary practice located at 1522 Penman Rd. , Jacksonville Beach FL 32250. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Beverly, Laura Nance can be contacted via phone (904) 253-2555.

Contact Information

Primary practice address
1522 Penman Rd. Jacksonville Beach FL 32250
Phone: (904) 253-2555
Fax: (904) 270-2559
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME59866 Florida

Profile Details

NPI number 1235189861
LBN Legal business name Beverly, Laura Nance
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Jan 2nd, 2013 - about 11 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 1235189861 NPPES
Florida MEDICAID 3740781-01
Florida MEDICAID 374078101

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