Beverly Mbamala, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

240128 Issued in AZ

Practice address

16751 W Harrison St
Goodyear, AZ 85338-2740

Phone

(313) 363-0977

NPI assigned

Oct 23, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1831971035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16751 W HARRISON ST",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16751 W HARRISON ST",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382740",
            "telephone_number": "313-363-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBAMALA",
        "first_name": "BEVERLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "240128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry Maupin, ACNP-BC, FNP-C
• Meghan Maurer
• Scott Michael Mayes, PCC
• Martin Francisco Mazon
• Mollanda Laura Mazzo, AG-ACNP
• Joseph D McArthur, P.T D.P.T.
• Cynthia McBroom, MSN,AGACNP,FNP, ENP
• Linda McCandless, D.O.
• Susan McCarthy-Robinson, NMHNP
• Seven McCasland

• Acute Care Nurse Practitioner in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Acute Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.