Individual
DR. BEVERLY ANN CLISBY GLASGOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP, ACNP
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(662) 349-4000
Mailing address
307 WISHING TREE LN, OXFORD, MS 38655-6133
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R503355
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02106036
—
MS
01
—
P00357312
RAILROAD MEDICARE
MS
Enumeration date
06/05/2006
Last updated
05/06/2014
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