Healthcare Provider Details

I. General information

NPI: 1407941214
Provider Name (Legal Business Name): BEVERLY SIMPLER CLARKE M.S.N., R.N., C.R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BROWN ST
CHESTERTOWN MD
21620-1435
US

IV. Provider business mailing address

29600 MORGNEC RD
MILLINGTON MD
21651-1220
US

V. Phone/Fax

Practice location:
  • Phone: 410-778-1420
  • Fax: 410-778-7086
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR109133
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: