Provider Demographics
NPI:1558192427
Name:BATEMAN, BEVERLY RUTH (MSN, RN)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:RUTH
Last Name:BATEMAN
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762-0086
Mailing Address - Country:US
Mailing Address - Phone:405-365-4361
Mailing Address - Fax:
Practice Address - Street 1:303 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762-0086
Practice Address - Country:US
Practice Address - Phone:405-365-4361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK192615163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health