Healthcare Provider Details

I. General information

NPI: 1700992898
Provider Name (Legal Business Name): JEFFREY L BEVAN DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 VETERANS DRIVE
THE DALLES OR
97058-9998
US

IV. Provider business mailing address

324 ENREDE LN
ST AUGUSTINE FL
32095-7437
US

V. Phone/Fax

Practice location:
  • Phone: 541-296-3937
  • Fax:
Mailing address:
  • Phone: 740-974-3535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number202202782NP-PP
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.08962
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number146814
License Number StateAK
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9438247
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: