Provider Demographics
NPI:1922313824
Name:NUCHOLS, BEVERLY ANN (ANP, PHD)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:ANN
Last Name:NUCHOLS
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Gender:F
Credentials:ANP, PHD
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Mailing Address - Street 1:20103 LAKE CHABOT RD
Mailing Address - Street 2:EDEN MEDICAL CENTER EMPLOYEE HEALTH CLINIC
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5305
Mailing Address - Country:US
Mailing Address - Phone:510-889-5067
Mailing Address - Fax:510-537-1443
Practice Address - Street 1:20103 LAKE CHABOT RD
Practice Address - Street 2:EDEN MEDICAL CENTER EMPLOYEE HEALTH CLINIC
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5305
Practice Address - Country:US
Practice Address - Phone:510-889-5067
Practice Address - Fax:510-537-1443
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA257198363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health