| Doctor Name: | GLORIA M BEERY |
| NPI Number: | 1043263064 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | AS, BSN, FNP |
| License Number: | NP122A |
| Business Practice Address: | 1545 E Leighfield Dr Suite 100 Meridian, ID - 836465371 |
| Business Phone Number: | 2088552710 |
| Business Fax Number: | 2088550883 |
| Mailing Address: | 1545 E Leighfield Dr, Suite 100 MERIDIAN |
| State: | ID |
| Postal Code: | 836465371 |
| Phone Number: | 2088552710 |
| Fax Number: | 2088550883 |
| NPI Enumeration Date: | 05/19/2006 |
| NPI Last Update Date: | 10/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP122A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |