Healthcare Provider Details

I. General information

NPI: 1174533830
Provider Name (Legal Business Name): BEVERLY A PEARSON FAMILY NURSE PRACTIT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNC STUDENT HEALTH SERVICES JAMES A. TAYLOR BLDG CB#7470
CHAPEL HILL NC
27514
US

IV. Provider business mailing address

710 RIDGELIFT LN
HILLSBOROUGH NC
27278-6646
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-2281
  • Fax: 919-966-0361
Mailing address:
  • Phone: 919-966-3650
  • Fax: 919-966-6248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number200374
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: