Beavers, John P

Beavers, John P is an individual health care provider with primary practice located at 5717 Oakland Dr , Portage MI 49024-1116. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Beavers, John P can be contacted via phone (269) 323-4473.

Contact Information

Primary practice address
5717 Oakland Dr Portage MI 49024-1116
Phone: (269) 323-4473
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 4704234332 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704234332 Michigan

Profile Details

NPI number 1003066143
LBN Legal business name Beavers, John P
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2008
Last updated Oct 13th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003066143 NPPES
Michigan Other 500C961050 BCBSM
Michigan MEDICAID 1003066143 BCBSM

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