| Doctor Name: | BEVERLY ANN HUDDLESTON |
| NPI Number: | 1063521870 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | AP30004059 |
| Business Practice Address: | 1000 S Scheuber Rd Pmg Sw Wa Centralia Women Center Centralia, WA - 985318877 |
| Business Phone Number: | 3603308950 |
| Business Fax Number: | 3603308955 |
| Mailing Address: | Po Box 3360, PORTLAND |
| State: | OR |
| Postal Code: | 972083360 |
| Phone Number: | 3604866508 |
| Fax Number: | |
| NPI Enumeration Date: | 08/29/2006 |
| NPI Last Update Date: | 11/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LX0001X |
| License Number: | AP30004059 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Obstetrics & Gynecology |
| Taxonomy Definition: | |