Provider Demographics
NPI:1467018523
Name:GEORGE-GAY, BEVERLY ELIZABETH (AGPCNP-BC)
Entity type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:ELIZABETH
Last Name:GEORGE-GAY
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11824 CLUB RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2752
Mailing Address - Country:US
Mailing Address - Phone:804-943-1395
Mailing Address - Fax:
Practice Address - Street 1:1200 W CARY ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-5410
Practice Address - Country:US
Practice Address - Phone:804-359-9375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176394363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024176394OtherLICENSE TO PRACTICE AS A NURSE PRACTITIONER
2018010120OtherAMERICAN NURSES CREDENTIALING CENTER CERTIFICATION