Individual
MRS. BEVERLY AIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN - CNP
Contact information
Practice address
100 S 2ND ST, THOMAS, OK 73669-8201
(580) 341-0870
Mailing address
100 S 2ND ST, THOMAS, OK 73669-8201
(580) 341-0870
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201601668RN
OR
163W00000X
Registered Nurse
R0105895
OK
363LF0000X
Family Nurse Practitioner
Primary
105895
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105895
APRN-CNP
OK
01
—
R0105895
OKLAHOMA RN LICENSE
OK
Enumeration date
04/05/2017
Last updated
03/17/2018
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