Beverly Jeanne Greenwald, FNP-BC NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R22718 Issued in ND

Practice address

117 22 St S
Fargo, ND 58103

Phone

(701) 261-4795

NPI assigned

Jun 22, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1740417302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 5TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58103",
            "telephone_number": "701-261-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 22 ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58103",
            "telephone_number": "701-261-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWALD",
        "first_name": "BEVERLY",
        "middle_name": "JEANNE",
        "credential": "FNP-BC NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R 158784-9",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R22718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayojemi Greene
• Azalea G Greene, RD, LD
• Susan G Greene, CRNA
• Nancy Wynn Greenley, BSW
• Emily Sue Greenstein, APRN, AGNP-C
• Kari Greer, M.S., CCC-SLP
• Alli Ann Greff, DNAP, CRNA
• Gregory D. Clark, MSW, LLC
• Liza Greminger
• Melinda T Gren, PT

• Family Nurse Practitioner in Fargo, ND
• Providers in Fargo, ND by specialty
• Family Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.