Doctor Name: | DEEANNA BENNETT BEAVER |
NPI Number: | 1033109038 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN, NP. |
License Number: | RN065304 APO1230 |
Business Practice Address: | 600 Polk St Houma, LA - 703604154 |
Business Phone Number: | 9858573601 |
Business Fax Number: | 9858573607 |
Mailing Address: | 1428 Dr. Beatrous Rd., THERIOT |
State: | LA |
Postal Code: | 70397 |
Phone Number: | 9858511985 |
Fax Number: | |
NPI Enumeration Date: | 10/21/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | RN065304 APO1230 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |