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General NPI Number Information
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NPI Number | 1194258319
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Entity Type | Individual
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Provider Name | KRISTEN BEVERLY NP
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Gender | Female
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Dates
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Enumeration Date | 04/05/2017
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 300 N COLLEGE ST
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City | GREENVILLE
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State | AL
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Zip | 36037
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Country | US
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Telephone | 334-382-2681
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Fax | 334-383-9918
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Provider Business Mailing Address
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Address Line | 221 COUNTRY CLUB DR
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City | GREENVILLE
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State | AL
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Zip | 36037
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Country | US
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Telephone | 334-782-7757
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Fax | 334-383-9918
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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 | 1-107936
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License Number State | AL
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