Provider Demographics
NPI:1659678878
Name:BEERLEY, MAGGIE ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:ELIZABETH
Last Name:BEERLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:310-825-6836
Mailing Address - Fax:310-206-3607
Practice Address - Street 1:200 PETER MORTON MEDICAL BLDG
Practice Address - Street 2:365C
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-825-6836
Practice Address - Fax:310-206-3607
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARN 690528163W00000X
CARN690528163WN0300X
CANP20508363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No163WN0300XNursing Service ProvidersRegistered NurseNephrology