MEDICARE: BEVERLY FUGLER

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	36582	TN

General Provider Information

NPI Number	:	1801634589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY FUGLER

Provider Business Mailing Address
First Line	:	40157 BARBARA RD
Second Line	:
City	:	PRAIRIEVILLE
State	:	LA
Zip	:	70769-5233
Country	:	US
Telephone Number	:	225-328-5387
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 WESLEY DR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38116-6499
Country	:	US
Telephone Number	:	901-516-3700
Fax Number	:

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

Provider Enumeration Date	:	07/17/2024
Last Update Date	:	07/17/2024

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Directions to “ BEVERLY FUGLER ” Practice Location

Language	Start Address	Practice Location

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