Provider Demographics
NPI:1114409554
Name:CROYLE, BEVERLY ANN (LPN, WCC)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:ANN
Last Name:CROYLE
Suffix:
Gender:F
Credentials:LPN, WCC
Other - Prefix:MISS
Other - First Name:BEVERLY
Other - Middle Name:ANN
Other - Last Name:SMIDDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:145 CHRISTINE CT.
Mailing Address - Street 2:
Mailing Address - City:EASTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44095
Mailing Address - Country:US
Mailing Address - Phone:440-487-6485
Mailing Address - Fax:
Practice Address - Street 1:145 CHRISTINE CT.
Practice Address - Street 2:
Practice Address - City:EASTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44095
Practice Address - Country:US
Practice Address - Phone:440-487-6485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-01
Last Update Date:2018-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH148191.MEDD-IV251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care