Provider Demographics
NPI:1740431311
Name:FIRTH, BEVERLY R (RN, MN, CNS)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:R
Last Name:FIRTH
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Gender:F
Credentials:RN, MN, CNS
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Other - First Name:
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Mailing Address - Street 1:5400 GIBSON BLVD SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-4729
Mailing Address - Country:US
Mailing Address - Phone:505-262-7960
Mailing Address - Fax:505-232-1368
Practice Address - Street 1:3901 CARLISLE BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4503
Practice Address - Country:US
Practice Address - Phone:505-262-3851
Practice Address - Fax:505-262-7040
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMCNS00208364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist