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NPI Code Detail

MEDICARE: VALERIE BEAVERS APRN

MEDICARE: VALERIE BEAVERS APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse PractitionerA003866AR

General Provider Information

NPI Number : 1851734453
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIE BEAVERS APRN
Provider Business Mailing Address
First Line : 1901 BISCAYNE DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72227-3951
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5315 W 12TH ST
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72204-1858
Country : US
Telephone Number : 501-664-0941
Fax Number : 501-666-3956
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2013
Last Update Date : 01/20/2020

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