Individual
BEVERLY FAUSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
706 LEFFERTS AVE, APT B1, BROOKLYN, NY 11203-1052
(347) 488-4820
Mailing address
706 LEFFERTS AVE, APT B1, BROOKLYN, NY 11203-1052
(347) 488-4820
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
207544
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207544
NYS NURSING LICENSE LPN
NY
Enumeration date
02/22/2010
Last updated
02/22/2010
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