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General NPI Number Information
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NPI Number | 1710218946
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Entity Type | Individual
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Provider Name | BEVERLY C. PEOPLES PH.D. R.N.
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Gender | Female
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Dates
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Enumeration Date | 01/28/2010
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Last Update Date | 01/28/2010
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Provider Practice Location Address
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Address Line | 12800 E WARREN AVE
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City | DETROIT
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State | MI
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Zip | 48215-2061
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Country | US
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Telephone | 313-824-8000
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Fax | 313-924-5589
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Provider Business Mailing Address
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Address Line | 12800 E WARREN AVE
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City | DETROIT
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State | MI
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Zip | 48215-2061
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Country | US
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Telephone | 313-824-8000
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Fax | 313-924-5589
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704119422
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 4704119422
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 4704119422
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 4704119422
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License Number State | MI
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