Provider Demographics
NPI:1942291513
Name:HOCKENBERGER, BEVERLY MILES (PA)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:MILES
Last Name:HOCKENBERGER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:530 WEST WEBB AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217
Mailing Address - Country:US
Mailing Address - Phone:336-228-8316
Mailing Address - Fax:336-227-9750
Practice Address - Street 1:530 WEST WEBB AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217
Practice Address - Country:US
Practice Address - Phone:336-228-8316
Practice Address - Fax:336-227-9750
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101082363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant