Most Relevant Information
Provider Data
| NPI Number: | 1003802406 |
| Provider Name: | BEVERLY JO GANN RNC,WHNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LW0102X |
| Specialty: | Nurse Practitioner |
| License Number: | RN 091078 |
Most Important Dates
| Enumeration Date: | 09/21/2005 |
| Last Updated: | 06/16/2011 |
Provider Practice Location
2828 N NATIONAL AVE
DOCTORS HOSPITAL OF SPRINGFIELD, SPECIALTY CLINIC
SPRINGFIELD
MO
658034306
Practice Location Phone/Fax
| Phone: | 4178374000 |
| Fax: | 4178754724 |
Provider Mailing Location
4360 STATE HIGHWAY 176 E
CHESTNUTRIDGE
MO
656303021
Provider Mailing Phone/Fax
| Phone: | 4174430039 |
| Fax: |