Provider Demographics
NPI:1124891007
Name:SPEARS, BEVERLY J
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:J
Last Name:SPEARS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23380 COMSTOCK RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-1619
Mailing Address - Country:US
Mailing Address - Phone:440-376-3596
Mailing Address - Fax:
Practice Address - Street 1:23380 COMSTOCK RD
Practice Address - Street 2:
Practice Address - City:BEDFORD HTS
Practice Address - State:OH
Practice Address - Zip Code:44146-1619
Practice Address - Country:US
Practice Address - Phone:440-376-3596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty