Provider Demographics
NPI:1598737249
Name:CARAWAY, BEVERLY KAY (APRN)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:KAY
Last Name:CARAWAY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7417
Mailing Address - Country:US
Mailing Address - Phone:870-698-2100
Mailing Address - Fax:870-698-0109
Practice Address - Street 1:2230 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7417
Practice Address - Country:US
Practice Address - Phone:870-698-2100
Practice Address - Fax:870-698-0109
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01906363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR169143795Medicaid
ARQ60952Medicare UPIN
AR169143795Medicaid