Provider Demographics
NPI:1518784149
Name:BEAVERS, CHRYSTAL SHEREE (CNA/HHA/CPRTRANSPORT)
Entity type:Individual
Prefix:MRS
First Name:CHRYSTAL
Middle Name:SHEREE
Last Name:BEAVERS
Suffix:
Gender:F
Credentials:CNA/HHA/CPRTRANSPORT
Other - Prefix:MS
Other - First Name:CHRYSTAL
Other - Middle Name:
Other - Last Name:BEAVERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10971 NE 77TH PL
Mailing Address - Street 2:
Mailing Address - City:BRONSON
Mailing Address - State:FL
Mailing Address - Zip Code:32621-0001
Mailing Address - Country:US
Mailing Address - Phone:352-792-9506
Mailing Address - Fax:
Practice Address - Street 1:10971 NE 77TH PL
Practice Address - Street 2:
Practice Address - City:BRONSON
Practice Address - State:FL
Practice Address - Zip Code:32621-0001
Practice Address - Country:US
Practice Address - Phone:352-792-9506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL104414163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health