BEVERLY PROVO, GNPC
Nurse Practitioner - Family
Active
Individual
NPI: 1215096482
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Nurse Practitioner - Adult Health | 363LA2200X | No | F3041711 (NY) |
| Nurse Practitioner - Family | 363LF0000X | Yes | F3403661 (NY) |
Frequently Asked Questions
NPI 1215096482 is the National Provider Identifier for BEVERLY PROVO, GNPC, a Nurse Practitioner - Family provider located in Newark, NY. This NPI was enumerated on December 6, 2006.
BEVERLY PROVO, GNPC practices at 1208 DRIVING PARK AVE, Newark, NY 14513.
Quick Facts
- NPI
- 1215096482
- Type
- Individual
- Enumerated
- Dec 6, 2006
- Last Updated
- Jan 6, 2011
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