Most Relevant Information
Provider Data
| NPI Number: | 1003678921 |
| Provider Name: | EDUASVY LAURELLE VANBOKKLEN APRN, PMHNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | APRN11030675 |
Most Important Dates
| Enumeration Date: | 01/25/2024 |
| Last Updated: | 08/22/2024 |
Provider Practice Location
3919 TAMPA RD FL 1
OLDSMAR
FL
346773114
Practice Location Phone/Fax
| Phone: | 5616570254 |
| Fax: |
Provider Mailing Location
3919 TAMPA RD FL 1
OLDSMAR
FL
346773114
Provider Mailing Phone/Fax
| Phone: | 5616570254 |
| Fax: |