Individual
MRS. BEVERLY VIENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6201 N SUNCOAST BLVD, CRYSTAL RIVER, FL 34428-6712
(352) 795-8490
(352) 795-8555
Mailing address
5870 W INLAND CT, DUNNELLON, FL 34433-4670
(810) 305-1072
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4704224985
MI
363LF0000X
Family Nurse Practitioner
Primary
ARNP9286630
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001326000
—
FL
01
—
11518107
CAQH
FL
Enumeration date
08/24/2005
Last updated
03/07/2023
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