Provider Demographics
NPI:1508361726
Name:SPRIGGS, BEVERLY JEAN
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:JEAN
Last Name:SPRIGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 WHITE AVE
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-5717
Mailing Address - Country:US
Mailing Address - Phone:191-826-0987
Mailing Address - Fax:
Practice Address - Street 1:2006 WHITE AVE
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-5717
Practice Address - Country:US
Practice Address - Phone:191-826-0987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator