Provider Demographics
NPI:1003543208
Name:BEARD, BOBBI SCHYLENE (DNP)
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:SCHYLENE
Last Name:BEARD
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1135
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:WA
Mailing Address - Zip Code:98941-0014
Mailing Address - Country:US
Mailing Address - Phone:425-244-4121
Mailing Address - Fax:
Practice Address - Street 1:150 QUEENS LOOP
Practice Address - Street 2:
Practice Address - City:CLE ELUM
Practice Address - State:WA
Practice Address - Zip Code:98922-7801
Practice Address - Country:US
Practice Address - Phone:425-244-4121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-07
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61345170207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine