Individual
MRS. BEVERLY JANE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
251 N BAYOU ST, MOBILE, AL 36603-5827
(251) 690-8158
(251) 544-2188
Mailing address
PO BOX 2867, MOBILE, AL 36652-2867
(251) 690-8158
(251) 544-2188
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1036230
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011846
MEDICARE GROUP PAYEE NUMBER
AL
01
—
1063439065
SITE GROUP PAYEE NUMBER
AL
05
—
630000013
—
AL
Enumeration date
03/31/2006
Last updated
06/23/2009
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