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Individual

MRS. BEVERLY H WEATHERSPOON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1005 DR DB TODD JR BLVD, NASHVILLE, TN 37208-3501
(615) 327-5584
Mailing address
809 USHER DR, MADISON, TN 37115-4292
(615) 868-6611

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA0000001454
TN
363AS0400X
Surgical Physician Assistant
Primary
1454
TN

Other

Enumeration date
11/01/2006
Last updated
03/03/2017
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