Provider Demographics
NPI:1225356314
Name:CRANE, BEVERLY J (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:J
Last Name:CRANE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 HENSON RD
Mailing Address - Street 2:
Mailing Address - City:CLINTONVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:24931-9715
Mailing Address - Country:US
Mailing Address - Phone:304-392-5670
Mailing Address - Fax:
Practice Address - Street 1:202 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-1108
Practice Address - Country:US
Practice Address - Phone:304-647-6470
Practice Address - Fax:304-647-6490
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV69341163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool