Provider Demographics
NPI:1801210141
Name:CRANFORD, BEVERLY MARIA (CPM, MSM, LM)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:MARIA
Last Name:CRANFORD
Suffix:
Gender:F
Credentials:CPM, MSM, LM
Other - Prefix:
Other - First Name:B MARIA
Other - Middle Name:
Other - Last Name:CRANFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPM MSM
Mailing Address - Street 1:1825 GLENN BLVD SW # 166
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35968-3533
Mailing Address - Country:US
Mailing Address - Phone:256-330-7008
Mailing Address - Fax:706-984-5395
Practice Address - Street 1:6245 VANCE RD STE A
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-0307
Practice Address - Country:US
Practice Address - Phone:770-421-5927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9053472-3400176B00000X
ALLM-0016176B00000X
374J00000X
TN120176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
13643934OtherCAQH