Organization · NPI-2

A1 Medical & Behavioral Health LLC

Nurse Practitioner, Adult Health · St Petersburg, FL

NPI number1689119174

StatusActive

Last updated in NPPESJan 9, 2017

Details

NPI: 1689119174
Entity type: Organization (NPI-2)
Legal business name: A1 Medical & Behavioral Health LLC
Organization subpart: No
Enumeration date: Dec 20, 2016
Last updated: Jan 9, 2017

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LA2200X	Nurse Practitioner, Adult Health	–	–	Yes
363LG0600X	Nurse Practitioner, Gerontology	–	–
363LP0808X	Nurse Practitioner, Psych/Mental Health	–	–

Practice location

2822 54th Ave S # 215
Suite 215
St Petersburg, FL 33712-4610

Phone 727-218-8961

Mailing address

2822 54th Ave S # 215
Suite 215
St Petersburg, FL 33712-4610

Phone 727-218-8961

Authorized official

Angela Denise Harvey
Arnp
7272188961

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