Healthcare Provider Details

I. General information

NPI: 1417014820
Provider Name (Legal Business Name): BEVERLY ANN SILVEIRA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 N FRESNO ST
FRESNO CA
93720-2941
US

IV. Provider business mailing address

405 E MERCED ST
FOWLER CA
93625-2318
US

V. Phone/Fax

Practice location:
  • Phone: 559-448-4555
  • Fax:
Mailing address:
  • Phone: 559-834-1753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN262539
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: