Provider Demographics
NPI:1588953756
Name:BEVERLEY, JASON (MS, RN, FNP-BC)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:BEVERLEY
Suffix:
Gender:M
Credentials:MS, RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 RESERVOIR RD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2113
Mailing Address - Country:US
Mailing Address - Phone:202-444-8888
Mailing Address - Fax:202-444-4315
Practice Address - Street 1:3800 RESERVOIR RD NW
Practice Address - Street 2:ROOM G2055
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2113
Practice Address - Country:US
Practice Address - Phone:202-444-8888
Practice Address - Fax:202-444-4315
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN58962363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily