MEDICARE: BEVERLEY J WEST 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	363LF0000X	Family Nurse Practitioner	APRN11000964	FL

General Provider Information

NPI Number	:	1598224560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLEY J WEST NP

Provider Business Mailing Address
First Line	:	10261 OAK MEADOW LN
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33449-5468
Country	:	US
Telephone Number	:	561-966-8009
Fax Number	:

Provider Business Practice Location Address
First Line	:	1236 ROYAL PALM BEACH BLVD
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-1602
Country	:	US
Telephone Number	:	561-774-8660
Fax Number	:

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

Provider Enumeration Date	:	03/18/2019
Last Update Date	:	11/14/2021

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