Provider Demographics
NPI:1013181213
Name:SPALDING, BEVERLEY W (ARNP)
Entity Type:Individual
Prefix:MS
First Name:BEVERLEY
Middle Name:W
Last Name:SPALDING
Suffix:
Gender:F
Credentials:ARNP
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 110637
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32911-0637
Mailing Address - Country:US
Mailing Address - Phone:201-233-4018
Mailing Address - Fax:
Practice Address - Street 1:1211 DATON RD SW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32908-7518
Practice Address - Country:US
Practice Address - Phone:321-723-4820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9177730363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health