Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | ARNP1624212 | FL |
NPI | 1023001633 |
---|---|
Provider Name | Linda K Beagle |
First Address | Tampa, FL 33606-4125 |
Second Address | Tampa, FL 33606-4125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 30/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
302019300 | (05) | FL |
500025344 | RAILROAD MEDICARE (01) | FL |
500027748 | RAILROAD MEDICARE (01) | FL |
500028922 | RAILROAD MEDICARE (01) | FL |
S30721 | (02) | |
Y6016 | BC/BS FLA (01) | FL |