Evelyn Beardsley

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Portales, NM

NPI 1124675699 · NPPES record last updated Aug 20, 2019

Key facts

NPI
1124675699
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1500 S Avenue K
Station 3, Shroc
Portales, NM 88130-8813
Phone
(575) 562-2160
NPI assigned
Aug 20, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern New Mexico University Current
since Nov 12, 2023
Accepting new patients

Locations

1500 S Avenue K
#3
Portales, NM 88130
Phone (575) 562-2156

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1500 S Avenue K
Station 3, Shroc
Portales, NM 88130-8813

Mailing address

1500 S Avenue K
Station 3, Shroc
Portales, NM 88130

Other providers in Portales, NM

All providers in Portales, NM · Student in an Organized Health Care Education/Training Program in New Mexico

Sources for this page

Verify at the official NPI Registry.