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1477685311
NICOLE S BEAVERS
CLINTON, TN
NPI
1477685311
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Former Name
NICOLE SELF
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: TN 6963)
Enumeration Date
2007-03-09
Last Update Date
2022-10-03
Business Address
NICOLE S BEAVERS CPNP
2130 N. CHARLES SEIVERS BLVD SUITE 4
CLINTON, TN 37716-6705
Phone number: 865-457-4044
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Mailing Address
NICOLE S BEAVERS CPNP
PO BOX 15004
KNOXVILLE, TN 37901-5004
Phone number: 865-541-8895
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