Provider Demographics
NPI:1306843644
Name:DAVIS BYE, BEVERLY JUNE (CRNP)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:JUNE
Last Name:DAVIS BYE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16905 FLICKERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21120-9767
Mailing Address - Country:US
Mailing Address - Phone:410-343-0842
Mailing Address - Fax:
Practice Address - Street 1:16905 FLICKERWOOD RD
Practice Address - Street 2:
Practice Address - City:PARKTON
Practice Address - State:MD
Practice Address - Zip Code:21120
Practice Address - Country:US
Practice Address - Phone:410-456-2182
Practice Address - Fax:410-343-0842
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR075319363LP0808X
MDRN075319363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD019241M72Medicare PIN
MD082NL399Medicare UPIN
DC019241M72Medicare UPIN
MD082NL399Medicare PIN