Individual
MARY ALICE BEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
202 MEDICAL CAMPUS DR, YCHD, BURNSVILLE, NC 28714-9004
(828) 682-6118
(828) 682-6262
Mailing address
365 LAUREL ACRES RD, BURNSVILLE, NC 28714-8069
(828) 682-6118
(828) 682-6262
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
023569
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023569
STATE LICENSE NUMBER
NC
Enumeration date
01/29/2007
Last updated
07/08/2007
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