Provider Demographics
NPI:1093518565
Name:DE PAZ, BEVERLY DIANA (APRN)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:DIANA
Last Name:DE PAZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1155 MILL ST # M14
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-2400
Mailing Address - Fax:775-982-2410
Practice Address - Street 1:1500 E 2ND ST STE 400
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1198
Practice Address - Country:US
Practice Address - Phone:775-982-2400
Practice Address - Fax:775-982-2410
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV811847363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV811847OtherNV APRN
NV16499629OtherCAQH