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Individual

BEVERLY A ECHOLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
2005 TOWN CENTER BLVD, ODENTON, MD 21113-1774
(601) 405-0374
Mailing address
819 REECE RD, SEVERN, MD 21144-7500
(601) 405-0374

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R262168
MD
363LF0000X
Family Nurse Practitioner
R857333
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00200062
MS
01
12660742
CAQH
MS
01
315084YV3Y
MS MEDICARE
MS
01
5803866
AETNA
MS
Enumeration date
06/12/2013
Last updated
09/30/2023
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