Provider Demographics
NPI:1851460307
Name:DRAUDT, BEVERLY (RN, CNM, WHNP)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:DRAUDT
Suffix:
Gender:F
Credentials:RN, CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2739
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482
Mailing Address - Country:US
Mailing Address - Phone:707-463-8000
Mailing Address - Fax:707-462-1111
Practice Address - Street 1:1050 N STATE ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-3414
Practice Address - Country:US
Practice Address - Phone:707-463-8000
Practice Address - Fax:707-462-1111
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN459726163W00000X
CACNM1219176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP29674Medicare UPIN