MEDICARE: BEVERLY J UHLENHAKE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	NP05008	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	9282991	OTHER	OH	MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023018942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY J UHLENHAKE NP

Provider Business Mailing Address
First Line	:	830 W MAIN ST
Second Line	:
City	:	COLDWATER
State	:	OH
Zip	:	45828-1626
Country	:	US
Telephone Number	:	567-890-7143
Fax Number	:	419-586-0812

Provider Business Practice Location Address
First Line	:	1830 UNION CITY RD
Second Line	:
City	:	FORT RECOVERY
State	:	OH
Zip	:	45846-9315
Country	:	US
Telephone Number	:	419-375-4144
Fax Number	:	419-375-4361

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	10/09/2025

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