Individual
BEVERLY A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
500 W RIVER DR, DAVENPORT, IA 52801-1014
(563) 336-3000
(563) 336-3044
Mailing address
500 W RIVER DR, DAVENPORT, IA 52801-1014
(563) 336-3000
(563) 336-3044
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
C030799
IA
363LP0200X
Pediatric Nurse Practitioner
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02874
IA BCBS SEEN IN DAVENPORT
IA
01
—
079471
HEALTH ALLIANCE
—
01
—
42106072440
JOHN DEERE HEALTH
IA
01
—
5200098
CONTROLLED SUBSTANCE#
IA
01
—
93327
IA BCBS SEEN IN MOLINE
IA
01
—
93357
IA BCBS SEEN IN RI
IA
01
—
IA0140
JOHN DEERE EDI#
IA
01
—
S53434
UPIN
—
Enumeration date
09/23/2005
Last updated
03/07/2023
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