Provider Demographics
NPI:1962757641
Name:JAMES, BEVERLY ANN (RN)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:ANN
Last Name:JAMES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 EDWARD DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-2223
Mailing Address - Country:US
Mailing Address - Phone:937-286-2221
Mailing Address - Fax:
Practice Address - Street 1:1105 EDWARD DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45420-2223
Practice Address - Country:US
Practice Address - Phone:937-286-2221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251219163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse