Most Relevant Information
Provider Data
| NPI Number: | 1003204660 |
| Provider Name: | BEVERLIE HOUSER AGPCNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LG0600X |
| Specialty: | Nurse Practitioner |
| License Number: | 4704266184 |
Most Important Dates
| Enumeration Date: | 01/06/2015 |
| Last Updated: | 01/06/2015 |
Provider Practice Location
4190 24TH AVE
FORT GRATIOT
MI
480593882
Practice Location Phone/Fax
| Phone: | 8109897788 |
| Fax: | 8109897799 |
Provider Mailing Location
4190 24TH AVE
FORT GRATIOT
MI
480593882
Provider Mailing Phone/Fax
| Phone: | 8109897788 |
| Fax: | 8109897799 |