Provider Demographics
NPI:1942317870
Name:PHILIPPI, BEVERLY J (APRN, BC)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:J
Last Name:PHILIPPI
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 S 48TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1283
Mailing Address - Country:US
Mailing Address - Phone:402-483-3333
Mailing Address - Fax:402-483-3297
Practice Address - Street 1:1600 S 48TH ST
Practice Address - Street 2:SUITE 600
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1275
Practice Address - Country:US
Practice Address - Phone:402-483-3333
Practice Address - Fax:402-483-3297
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE110506363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47084496100Medicaid
NE500023612Medicare PIN
NE47084496100Medicaid
NEP52529Medicare UPIN