Individual
MS. BEVERLY LOUISE EARSING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, IBCLC
Contact information
Practice address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-4646
Mailing address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-4646
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
875748
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184729493
MEDICAID, MEDICARE PIN
AZ
Enumeration date
04/13/2009
Last updated
04/13/2009
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