Healthcare Provider Details

I. General information

NPI: 1417941121
Provider Name (Legal Business Name): BEVERLY A ANDERSON RNCS/APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MARKET SQ SUITE 206
AMESBURY MA
01913-2497
US

IV. Provider business mailing address

5 MARKET SQ SUITE 206
AMESBURY MA
01913-2497
US

V. Phone/Fax

Practice location:
  • Phone: 978-388-0606
  • Fax: 978-388-0006
Mailing address:
  • Phone: 978-388-0606
  • Fax: 978-388-0006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRNPC 74534
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: