Provider Demographics
NPI:1992072029
Name:GREGORY, BEVERLY MCPHERSON (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:MCPHERSON
Last Name:GREGORY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:MCPHERSON
Other - Last Name:GREGORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:DUMC 3677
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-681-9937
Mailing Address - Fax:919-681-7163
Practice Address - Street 1:DUMC 3677
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-681-9937
Practice Address - Fax:919-681-7163
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC153196163W00000X
NCF0811319363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse