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General NPI Number Information
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NPI Number | 1548529084
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Entity Type | Individual
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Provider Name | BEVERLY LYNN MAUGER NP
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Gender | Female
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Dates
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Enumeration Date | 05/03/2012
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 6326 CONSTITUTION DR
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City | FT WAYNE
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State | IN
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Zip | 46804
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Country | US
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Telephone | 260-515-3275
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Fax | 888-803-6843
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Provider Business Mailing Address
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Address Line | 8488 FRITZ ROAD
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City | FORT WAYNE
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State | IN
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Zip | 46818
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Country | US
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Telephone | 260-450-9665
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Fax | 888-803-6843
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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 | 71004010A
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License Number State | IN
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