Provider Demographics
NPI:1942040126
Name:BEASON, NEVAEH AMARU
Entity type:Individual
Prefix:
First Name:NEVAEH
Middle Name:AMARU
Last Name:BEASON
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:PO BOX 235
Mailing Address - Street 2:
Mailing Address - City:CROSBY
Mailing Address - State:ND
Mailing Address - Zip Code:58730-0235
Mailing Address - Country:US
Mailing Address - Phone:414-553-3435
Mailing Address - Fax:701-965-2426
Practice Address - Street 1:PO BOX 235
Practice Address - Street 2:
Practice Address - City:CROSBY
Practice Address - State:ND
Practice Address - Zip Code:58730-0235
Practice Address - Country:US
Practice Address - Phone:414-553-3435
Practice Address - Fax:701-965-2426
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant