Provider Demographics
NPI:1205287851
Name:BUDHNA, ALICIA STEFANIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:STEFANIE
Last Name:BUDHNA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6533 FILLMORE ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-7635
Mailing Address - Country:US
Mailing Address - Phone:954-200-4302
Mailing Address - Fax:
Practice Address - Street 1:6533 FILLMORE ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-7635
Practice Address - Country:US
Practice Address - Phone:954-200-4302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLAPRN11034817163WP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN11034817OtherANCC