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Beverly J Provo, GNPC
Family Nurse Practitioner in Newark, New York
NPI 1215096482

Beverly J Provo is a Family Nurse Practitioner based in Newark, NY and is specialized in Family. Beverly J Provo practices in Newark, NY and has the professional credentials of GNPC. The NPI Number for Beverly J Provo is 1215096482 and holds a License No. F3041711 (New York).

The current practice location address for Beverly J Provo is 1208 Driving Park Ave, Newark, NY and can be reached out via phone at 315-359-2640.

Location: 1208 Driving Park Ave, Newark, NY, 14513-1057
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Provider Profile Details
NPI Number
1215096482
Provider Name
Beverly J Provo
Credential
GNPC
Provider Entity Type
Individual
Gender
Female
Address
1208 Driving Park Ave, Newark, NY, 14513-1057
Phone Number
315-359-2640
Fax Number
Provider Enumeration Date
12/06/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1208 Driving Park Ave
City
State
Zip
14513-1057
Phone Number
315-359-2640
Fax Number
person
Provider Business Mailing Address Details
Address
1208 Driving Park Ave
City
State
Zip
14513-1057
Phone Number
315-359-2640
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
License No.
F3403661 (New York)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
F3041711 (New York)
Definition
Definition to come...
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