Beveridge, Phyllis Ann
Beveridge, Phyllis Ann is an individual health care provider with primary practice located at 915 River Rd , Middletown CT 06457-3921. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Beveridge, Phyllis Ann can be contacted via phone (860) 704-4045.Contact Information
Primary practice address
915 River Rd
Middletown CT 06457-3921
Phone: (860) 704-4045
Fax: (860) 704-4032
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 001808 | Connecticut |
Profile Details
| NPI number | 1194945634 |
|---|---|
| LBN Legal business name | Beveridge, Phyllis Ann |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194945634 | NPPES |
| Connecticut | MEDICAID | 004192514-00 |
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