Provider Demographics
NPI:1750727574
Name:NORTH, BEVERLY JOAN (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:JOAN
Last Name:NORTH
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:GREEN RIVER
Mailing Address - State:WY
Mailing Address - Zip Code:82935-5460
Mailing Address - Country:US
Mailing Address - Phone:307-871-3631
Mailing Address - Fax:
Practice Address - Street 1:511 N 12TH ST E
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-3809
Practice Address - Country:US
Practice Address - Phone:307-463-7160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-20
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY13286.1218363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily