Provider Demographics
NPI:1942487285
Name:RAND, BEVERLY JEAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:JEAN
Last Name:RAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:BEVERLY
Other - Middle Name:JEAN
Other - Last Name:FRAZIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:N8 W31265 CONCORD LANE
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018
Mailing Address - Country:US
Mailing Address - Phone:262-646-3126
Mailing Address - Fax:262-646-3126
Practice Address - Street 1:2000 NATIONAL BLVD
Practice Address - Street 2:ZABLOCKI VAMC
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53032
Practice Address - Country:US
Practice Address - Phone:414-384-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI88859030163W00000X, 163WC0200X
WI8859030163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical