Individual
BEVERLY JANE FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
160 E MAIN ST, PORT JERVIS, NY 12771-2114
(845) 807-2239
Mailing address
56 BRISTOL CIR, ROCK HILL, NY 12775-6002
(845) 807-2239
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310954
NY
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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