Individual
BEVERLY ANN HUDDLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1000 S SCHEUBER RD, PMG SW WA CENTRALIA WOMEN CENTER, CENTRALIA, WA 98531-8877
(360) 330-8950
(360) 330-8955
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(360) 486-6508
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
AP30004059
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9612268
—
WA
Enumeration date
08/29/2006
Last updated
05/21/2021
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