Individual
MR. BRUCE BRIAN BEARDSLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
12058 SAN JOSE BLVD, STE 1003, JACKSONVILLE, FL 32223-8667
(904) 321-9875
(904) 321-9890
Mailing address
5623 ORTEGA FARMS BLVD, JACKSONVILLE, FL 32244-2335
(904) 994-2706
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
9273193
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP9273193
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108369900
—
FL
Enumeration date
05/24/2016
Last updated
04/30/2021
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