| Doctor Name: | MS. NICOLE BEVANS |
| NPI Number: | 1205246907 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN-CNP |
| License Number: | NP-1411A |
| Business Practice Address: | 702 E Young Ave Warrensburg, MO - 640939610 |
| Business Phone Number: | 8005251483 |
| Business Fax Number: | |
| Mailing Address: | 1253 Vivian Dr, WARRENSBURG |
| State: | MO |
| Postal Code: | 640937866 |
| Phone Number: | 2088698004 |
| Fax Number: | |
| NPI Enumeration Date: | 05/02/2014 |
| NPI Last Update Date: | 11/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP-1411A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |