Beverly Datilus, FNP | |
500 Kirts Blvd Ste 200, Troy, MI 48084-4140 | |
(973) 441-3225 | |
Not Available |
Full Name | Beverly Datilus |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 500 Kirts Blvd Ste 200, Troy, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306534557 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 26NJ01307000 (New Jersey) | Primary |
Entity Name | Harmony Medical Services Of New Jersey Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649873183 PECOS PAC ID: 0446635510 Enrollment ID: O20220912000425 |
Mailing Address | Practice Location Address |
---|---|
Beverly Datilus, FNP 500 Kirts Blvd Ste 200, Troy, MI 48084-4140 Ph: (973) 441-3225 | Beverly Datilus, FNP 500 Kirts Blvd Ste 200, Troy, MI 48084-4140 Ph: (973) 441-3225 |
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