Individual
MAVRA E KEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, ARNP, BC
Contact information
Practice address
1831 GILMORE AVE, LAKELAND, FL 33805-3017
(863) 519-0575
(863) 582-9251
Mailing address
PO BOX 1559, BARTOW, FL 33831-1559
(863) 519-0575
(863) 582-9251
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN1613842
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013462600
—
FL
01
—
566717000
MAGELLAN
FL
Enumeration date
09/26/2005
Last updated
11/25/2019
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