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General NPI Number Information
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NPI Number | 1942574322
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Entity Type | Individual
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Provider Name | ELIZABETH BEVAN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/01/2012
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 930 N CHESTER AVE
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City | PASADENA
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State | CA
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Zip | 91104-2941
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Country | US
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Telephone | 626-644-7168
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Fax |
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Provider Business Mailing Address
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Address Line | 10005 FLOWER ST
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City | BELLFLOWER
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State | CA
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Zip | 90706-5412
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Country | US
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Telephone | 562-526-3000
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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 | NP CERTIFICATE 21281
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License Number State | CA
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