Individual
ROSS ANDREW BEAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1301 E H ST, MC COOK, NE 69001-3482
(308) 344-2650
Mailing address
PO BOX 1328, MC COOK, NE 69001-1328
(308) 344-2650
(308) 340-8358
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101049
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101049
STATE OF NEBRASKA DHHS
NE
Enumeration date
07/30/2008
Last updated
12/22/2020
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