| Doctor Name: | KRISTINE BEAVER |
| NPI Number: | 1710393830 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 364787915 |
| Business Practice Address: | 730 East 500 South Blanding, UT - 84511 |
| Business Phone Number: | 4357733988 |
| Business Fax Number: | |
| Mailing Address: | 730 East 500 South, BLANDING |
| State: | UT |
| Postal Code: | 84511 |
| Phone Number: | 4357733988 |
| Fax Number: | |
| NPI Enumeration Date: | 07/09/2014 |
| NPI Last Update Date: | 07/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SA2200X |
| License Number: | 364787915 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |