Provider Demographics
NPI:1417941121
Name:ANDERSON, BEVERLY A (RNCS/APRN-BC)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:A
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RNCS/APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MARKET SQ
Mailing Address - Street 2:SUITE 206
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-2497
Mailing Address - Country:US
Mailing Address - Phone:978-388-0606
Mailing Address - Fax:978-388-0006
Practice Address - Street 1:5 MARKET SQ
Practice Address - Street 2:SUITE 206
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-2497
Practice Address - Country:US
Practice Address - Phone:978-388-0606
Practice Address - Fax:978-388-0006
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARNPC 74534364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA103995OtherHMO BLUE/MAGELLAN BEHAVIH
MA1111035OtherMCC/CIGNA
MA730962OtherTUFTS HEALTH PLAN
MA177994OtherMANAGED HEALTH NETWORK
MAPI 33053OtherPACIFICARE BEHAVIORAL HEA
MAPN0350OtherBCBS
MA010068OtherVALUE OPTIONS
MA213220OtherBEACON FALLON
MA213220OtherBEACON NEIGHBORHOOD HEALT
MA003091OtherHP/ VALUE OPTIONS
MAS031182OtherCHAMPUS
MA010068OtherTRICARE
MAPN0350OtherBCBS
MA003091OtherHP/ VALUE OPTIONS