Provider Demographics
NPI:1639114473
Name:MILLAN, BEVERLEY JOANNE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:BEVERLEY
Middle Name:JOANNE
Last Name:MILLAN
Suffix:
Gender:F
Credentials:ARNP
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 891
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-0891
Mailing Address - Country:US
Mailing Address - Phone:360-734-9095
Mailing Address - Fax:
Practice Address - Street 1:1530 ELLIS ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4905
Practice Address - Country:US
Practice Address - Phone:360-734-9007
Practice Address - Fax:360-647-7453
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007326363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner