Provider Demographics
NPI:1659083962
Name:BEAVERS, BRITTANY (WHNP-BC)
Entity type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:
Last Name:BEAVERS
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:MRS
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP-BC
Mailing Address - Street 1:880 N TENNESSEE AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-9401
Mailing Address - Country:US
Mailing Address - Phone:304-596-2149
Mailing Address - Fax:304-264-1577
Practice Address - Street 1:880 N TENNESSEE AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-9401
Practice Address - Country:US
Practice Address - Phone:304-596-2149
Practice Address - Fax:304-264-1577
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001269695163WN0002X
WV115647363LW0102X
WVWV115647363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care