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General NPI Number Information
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NPI Number | 1124466099
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Entity Type | Individual
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Provider Name | BEVERLY A ECHOLES FNP
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Gender | Female
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Dates
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Enumeration Date | 06/12/2013
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Last Update Date | 09/30/2023
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Provider Practice Location Address
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Address Line | 2005 TOWN CENTER BLVD
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City | ODENTON
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State | MD
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Zip | 21113-1774
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Country | US
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Telephone | 601-405-0374
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Fax |
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Provider Business Mailing Address
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Address Line | 819 REECE RD
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City | SEVERN
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State | MD
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Zip | 21144-7500
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Country | US
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Telephone | 601-405-0374
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R857333
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R262168
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License Number State | MD
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