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Individual

BEVERLY A. RIDGWAY

Active
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Individual

BEVERLY A. RIDGWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Taxonomy

Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
661264
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00T22Y
BCBS #
TX
05
111408401
TX
05
111408402
TX
Enumeration date
08/31/2006
Last updated
08/08/2011
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