Provider Demographics
NPI:1285463182
Name:BEAVER, DELIA MICHELLE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:DELIA
Middle Name:MICHELLE
Last Name:BEAVER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11452 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-8944
Mailing Address - Country:US
Mailing Address - Phone:352-361-3043
Mailing Address - Fax:
Practice Address - Street 1:216 NW 135TH WAY STE 10
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32669-3713
Practice Address - Country:US
Practice Address - Phone:352-260-4061
Practice Address - Fax:352-260-4071
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP11032852363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner