Provider Demographics
NPI:1326040940
Name:BEVIER, DONNA JEAN (FNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JEAN
Last Name:BEVIER
Suffix:
Gender:F
Credentials:FNP
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 728
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39566-0728
Mailing Address - Country:US
Mailing Address - Phone:228-327-7878
Mailing Address - Fax:
Practice Address - Street 1:2210 DENNY AVE
Practice Address - Street 2:PASCAGOULA URGENT CARE
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39567-3416
Practice Address - Country:US
Practice Address - Phone:228-372-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR719471363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00123967Medicaid
MSQ0624Medicare UPIN
MS500001412Medicare ID - Type Unspecified