Provider Demographics
NPI:1811078298
Name:BEADLE, VERA ANN (NP-C, PHMNP-BC)
Entity type:Individual
Prefix:MISS
First Name:VERA
Middle Name:ANN
Last Name:BEADLE
Suffix:
Gender:F
Credentials:NP-C, PHMNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HIGHWAY 2 W
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-3532
Mailing Address - Country:US
Mailing Address - Phone:701-665-2200
Mailing Address - Fax:701-665-2300
Practice Address - Street 1:200 HIGHWAY 2 W
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-3532
Practice Address - Country:US
Practice Address - Phone:701-665-2200
Practice Address - Fax:701-665-2300
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704201918163WP0808X, 363LF0000X
CO128553163WG0000X
NDR46932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice