Provider Demographics
NPI:1730304643
Name:BESWICK, MAUREEN C (APNC)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:C
Last Name:BESWICK
Suffix:
Gender:F
Credentials:APNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 EMERALD DR
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-5940
Mailing Address - Country:US
Mailing Address - Phone:609-653-6596
Mailing Address - Fax:
Practice Address - Street 1:408 BETHEL RD
Practice Address - Street 2:SUITE E
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2172
Practice Address - Country:US
Practice Address - Phone:609-926-3330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00037500363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJQ14062Medicare UPIN