1174533830 NPI number — MRS. BEVERLY A PEARSON FAMILY NURSE PRACTIT

Table of content: MRS. BEVERLY A PEARSON FAMILY NURSE PRACTIT (NPI 1174533830)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174533830 NPI number — MRS. BEVERLY A PEARSON FAMILY NURSE PRACTIT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PEARSON
Provider First Name:
BEVERLY
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FAMILY NURSE PRACTIT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174533830
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
710 RIDGELIFT LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HILLSBOROUGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27278-6646
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-966-3650
Provider Business Mailing Address Fax Number:
919-966-6248

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UNC STUDENT HEALTH SERVICES
Provider Second Line Business Practice Location Address:
JAMES A. TAYLOR BLDG CB#7470
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-966-2281
Provider Business Practice Location Address Fax Number:
919-966-0361
Provider Enumeration Date:
08/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  200374 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com