| NPI | 1811161813 |
|---|---|
| Former Name | BEVERLY JANE SHULL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN APN13413) |
| Additional Taxonomies | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: TN 13413) |
| 163W00000X Registered Nurse (Licence: TN RN129155) | |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2014-11-18 |