Healthcare Provider Details

I. General information

NPI: 1912507823
Provider Name (Legal Business Name): SARAH BEVIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH KELLEY

II. Dates (important events)

Enumeration Date: 10/29/2020
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 WEBSTER ST STE 8
HANOVER MA
02339-1227
US

IV. Provider business mailing address

41 DORIS AVE
NORWELL MA
02061-2027
US

V. Phone/Fax

Practice location:
  • Phone: 781-754-6545
  • Fax: 781-536-0016
Mailing address:
  • Phone: 508-887-1342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2272868
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: