Provider Demographics
NPI:1205105764
Name:HERSHEY, BRONWYN CAREY (APRN PMHNP-BC)
Entity type:Individual
Prefix:
First Name:BRONWYN
Middle Name:CAREY
Last Name:HERSHEY
Suffix:
Gender:F
Credentials:APRN PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 W ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2537
Mailing Address - Country:US
Mailing Address - Phone:800-457-4573
Mailing Address - Fax:800-443-6422
Practice Address - Street 1:118 W ORANGE ST
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2537
Practice Address - Country:US
Practice Address - Phone:800-457-4573
Practice Address - Fax:407-476-1213
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-29
Last Update Date:2022-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11012395363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1153723341Medicaid
2019080344OtherPSYCHIATRIC - MENTAL HEALTH NURSE PRACTITIONER
FLAPRN11012395OtherAPRN LICENSE