Provider Demographics
NPI:1144574245
Name:CAVERZASI, BECKY ADAMS (APRN)
Entity Type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:ADAMS
Last Name:CAVERZASI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 JESSE JEWELL PKWY SE STE 200
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3865
Mailing Address - Country:US
Mailing Address - Phone:770-297-7277
Mailing Address - Fax:
Practice Address - Street 1:1250 JESSE JEWELL PKWY SE STE 200
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3865
Practice Address - Country:US
Practice Address - Phone:770-297-7277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN189773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily