Provider Demographics
NPI:1629724216
Name:ROBEY, BEVERLY J
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:J
Last Name:ROBEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 MOUNTAIN PARK DR
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-8992
Mailing Address - Country:US
Mailing Address - Phone:304-816-6387
Mailing Address - Fax:330-481-6373
Practice Address - Street 1:16 MOUNTAIN PARK DR
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-8992
Practice Address - Country:US
Practice Address - Phone:304-816-6387
Practice Address - Fax:330-481-6373
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVE0362023747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider