Provider Demographics
NPI:1497000384
Name:HENRY, BEVERLEY DONNA (RN)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLEY
Middle Name:DONNA
Last Name:HENRY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 REMINGTON PL
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-3902
Mailing Address - Country:US
Mailing Address - Phone:914-235-0761
Mailing Address - Fax:914-235-0761
Practice Address - Street 1:124 REMINGTON PLACE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801
Practice Address - Country:US
Practice Address - Phone:914-235-0761
Practice Address - Fax:914-235-0761
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY472153163WH0200X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No251E00000XAgenciesHome Health