Provider Demographics
NPI:1932183647
Name:CAIL, BEVERLY A (DNP, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:A
Last Name:CAIL
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:MS
Other - First Name:BEVERLY
Other - Middle Name:A
Other - Last Name:SESTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 860
Mailing Address - Street 2:
Mailing Address - City:WHITERIVER
Mailing Address - State:AZ
Mailing Address - Zip Code:85941-0860
Mailing Address - Country:US
Mailing Address - Phone:928-338-4911
Mailing Address - Fax:928-338-5508
Practice Address - Street 1:200 W HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:WHITERIVER
Practice Address - State:AZ
Practice Address - Zip Code:85941-0860
Practice Address - Country:US
Practice Address - Phone:928-338-4911
Practice Address - Fax:928-338-5508
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP0837363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ617515Medicaid
CO25007777Medicaid
HSZ388RBUOtherWHITERIVER SU
HSZ388RBVOtherCBQ
HSZ388RBUOtherWHITERIVER SU
CO25007777Medicaid
HSZ240Medicare UPIN
HSZ388RBVOtherCBQ