Jucknath, Beverly Suzanne
Jucknath, Beverly Suzanne is an individual health care provider with primary practice located at 3003 W Dr Martin Luther King Jr Blvd Fl 2 , Tampa FL 33607-6307. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Jucknath, Beverly Suzanne can be contacted via phone (813) 321-6580.Contact Information
Primary practice address
3003 W Dr Martin Luther King Jr Blvd Fl 2
Tampa FL 33607-6307
Phone: (813) 321-6580
Fax: (813) 443-8185
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Nursing Service Providers / Critical Care Medicine | 163WC0200X | RN9361508 | Florida |
Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | APRN11003292 | Florida |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | APRN11003292 | Florida |
Profile Details
NPI number | 1235693268 |
---|---|
LBN Legal business name | Jucknath, Beverly Suzanne |
Credentials | APRN-C |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 23rd, 2019 |
Last updated | Jun 14th, 2024 - about 3 months 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1235693268 | NPPES |
Florida | MEDICAID | 106459800 |
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