Beverly B Nickerson, N.P

Primary specialty

SpecialistTaxonomy code 174400000X

License

NP # 12061 Issued in CA

Practice address

701 E 28TH St Ste 318
Long Beach, CA 90806-2785

Phone

(562) 290-8888

NPI assigned

Oct 26, 2006

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 identifiers 2

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952486243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E 28TH ST STE 318",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062785",
            "telephone_number": "562-290-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E 28TH ST STE 318",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062785",
            "telephone_number": "562-290-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "BEVERLY",
        "middle_name": "B",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "NP # 12061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "12061",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "300404",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janiya Nichols, MS, AMFT
• Jocelyn Nichols
• Lashawn Nichols, RDA
• Stephanie Nichols
• Patrick Nicholson
• Charlotte Stephanie Nicolas, FNP
• Colleen Nicolas
• Elijah Nicolas
• Leyla Guadalupe Nicolas
• Michael Mark Nicolas

• Specialist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.