Provider Demographics
NPI:1780887315
Name:JOACHIM, BEVERLY WILLIAMS (NP)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:WILLIAMS
Last Name:JOACHIM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 2ND ST SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4923
Mailing Address - Country:US
Mailing Address - Phone:540-342-2844
Mailing Address - Fax:540-342-3510
Practice Address - Street 1:1328 2ND ST SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4923
Practice Address - Country:US
Practice Address - Phone:540-342-2844
Practice Address - Fax:540-342-3510
Is Sole Proprietor?:No
Enumeration Date:2007-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024062345363LP0808X, 363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Not Answered363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal