Beverly Lyndele Mikus, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

RN064885 Issued in AZ

Practice address

410 Malacate St
Ajo, AZ 85321

Phone

(520) 738-7703

Fax

(520) 387-6036

NPI assigned

Feb 6, 2008

Last updated

Feb 6, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Beverly Lyndele Bonney Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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

• Pima Health System

  • Health Maintenance Organization
  • Tucson, AZ
  • NPI 1952430548
  NPD (past)

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1821276452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 S COUNTRY CLUB RD",
            "address_2": "STE 400",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85714",
            "telephone_number": "520-243-8000",
            "fax_number": "520-243-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MALACATE ST",
            "city": "AJO",
            "state": "AZ",
            "postal_code": "85321",
            "telephone_number": "520-738-7703",
            "fax_number": "520-387-6036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKUS",
        "first_name": "BEVERLY",
        "middle_name": "LYNDELE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "AZ",
            "license": "RN064885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEVERLY",
            "last_name": "BONNEY",
            "middle_name": "LYNDELE",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffrey R Lavoy, M.D.
• Lifetorch Recovery Center & Wellness LLC
• Lifetorch Recovery Center & Wellness LLC
• Jennifer K Lim, DDS
• Michael Mason
• Jessica Montes
• Mujica Dos Fronteras
• Boriana Rousseva Nikolova, FNP-BC
• Portable Practical Education Preparation Inc.
• Catrina Yvette Prather

• Home Health Registered Nurse in Ajo, AZ
• Providers in Ajo, AZ by specialty
• Home Health Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; 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.