Provider Demographics
NPI:1356557300
Name:GRIFFIN, BEVERLY E (FNP)
Entity type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:E
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:BEVERLY
Other - Middle Name:E
Other - Last Name:MOSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:4122 MIDSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-1726
Mailing Address - Country:US
Mailing Address - Phone:281-403-6411
Mailing Address - Fax:
Practice Address - Street 1:10505 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8076
Practice Address - Country:US
Practice Address - Phone:713-436-1617
Practice Address - Fax:713-436-3681
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX249481363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily