Individual
MS. BEVERLY TANAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
2901 FORD ST, GOLDEN, CO 80401-2422
(303) 273-2736
Mailing address
2446 S TENNYSON ST, DENVER, CO 80219-6401
(303) 618-3167
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN-56697
CO
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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