| NPI | 1679914154 |
|---|---|
| Former Name | MELISSA B BEAVERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR 228907) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07438) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2024-07-12 |