Provider Demographics
NPI:1598053076
Name:SCARBROUGH, BEVERLY A (ANP)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:A
Last Name:SCARBROUGH
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13431 FM 901
Mailing Address - Street 2:
Mailing Address - City:SADLER
Mailing Address - State:TX
Mailing Address - Zip Code:76264-3114
Mailing Address - Country:US
Mailing Address - Phone:903-267-0860
Mailing Address - Fax:
Practice Address - Street 1:13431 FM 901
Practice Address - Street 2:
Practice Address - City:SADLER
Practice Address - State:TX
Practice Address - Zip Code:76264-3114
Practice Address - Country:US
Practice Address - Phone:903-267-0860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX244703363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health