David M Beveridge, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Mount Vernon, IL
NPI 1720180508 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720180508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- Practice address
- 605 N 12TH St
Mount Vernon, IL 62864-2857 - Phone
- (618) 241-1108
- Fax
- (618) 241-3805
- NPI assigned
- Sep 2, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 309000661 | IL | MD | Certified Registered Nurse Anesthetist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | IL | Yes |
Addresses
Primary practice location
605 N 12TH St
Mount Vernon, IL 62864-2857
Mailing address
4227 Lincolnshire Drive
Mount Vernon, IL 62864-2157
Phone (618) 242-2317
Other providers in Mount Vernon, IL
- Debbie Jane Bendersky
- Jason Dwight Bernard
- Jessica Marie Berry I
- Don Edward Bertschi
- Bethel Grade School District #82
- Nathan Biggerstaff Andrew Biggerstaff
- William Alan Bishop
- Eric Lee Black
- Clarisa Blakemore
- Helaine Sue Blomenkamp
All providers in Mount Vernon, IL · Certified Registered Nurse Anesthetist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.