Individual
MRS. BEVERLY JO MORTIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1330 N RACE ST, GLASGOW, KY 42141-3465
(270) 629-5111
(270) 783-3760
Mailing address
201 PARK ST, BOWLING GREEN, KY 42101-1759
(270) 780-2497
(270) 783-3750
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3005266
KY
363LF0000X
Family Nurse Practitioner
5266P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100072050
—
KY
Enumeration date
08/05/2007
Last updated
02/22/2024
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