Individual
PETER A. BEVERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
303 PARKWAY DRIVE NE, PMB 404, ATLANTA, GA 30312-1212
(404) 265-4424
(404) 265-3894
Mailing address
PO BOX 932925, ATLANTA, GA 31193-2925
(800) 364-9216
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN127632
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114180239
TRICARE
—
05
—
670634888E
—
GA
05
—
670634888F
—
GA
Enumeration date
07/09/2008
Last updated
11/12/2010
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