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Individual

JOHN D. BEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
110 N BROWN ST, CHADBOURN, NC 28431-1716
(910) 654-1701
(910) 654-5701
Mailing address
110 N BROWN ST, CHADBOURN, NC 28431-1716
(910) 654-1701
(910) 654-5701

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
005000684
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
344634A
NC
05
344634C
NC
Enumeration date
05/13/2006
Last updated
06/01/2012
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