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Individual
JENNIFER ELIZABETH BEVACQUA
Active
Individual
JENNIFER ELIZABETH BEVACQUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200041072RN
OR
363LA2100X
Acute Care Nurse Practitioner
200550067NP
OR
363LA2100X
Acute Care Nurse Practitioner
AP60821940
WA
363LP0200X
Pediatric Nurse Practitioner
Primary
200550067NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270026
—
OR
Enumeration date
08/03/2006
Last updated
12/04/2025
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