Provider Demographics
NPI:1639886153
Name:HESS, BEVERLY ANN
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:ANN
Last Name:HESS
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 1:1250 PINE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-4945
Mailing Address - Country:US
Mailing Address - Phone:304-825-1417
Mailing Address - Fax:
Practice Address - Street 1:SUITE 120 EASTLAND SQUARE
Practice Address - Street 2:503 MORGANTOWN AVE
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554
Practice Address - Country:US
Practice Address - Phone:304-363-7375
Practice Address - Fax:304-471-2488
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker