MRS. BEVERLY JANE WADDELL (NPI# 1811161813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811161813 |
| Entity Type | Individual |
| Full Name | MRS. BEVERLY JANE WADDELL |
| Other Name | BEVERLY JANE SHULL |
| Credential | ANP, GCNS |
| Practice Address |
105 W Stone Dr Ste 5c Kingsport TN 37660-3365 |
| Mailing Address |
Po Box 9 Kingsport TN 37662-0009 |
| Practice Telephone | 4233787645 |
| Practice Fax Number | 4233923863 |
| Mailing Telephone | 4238572066 |
| Mailing Fax Number | 4238572070 |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2014-11-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN129155 | TN | Nursing Service Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
APN13413 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SG0600X |
Clinical Nurse Specialist Specialization: Gerontology |
13413 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1510164 | 05 |
| Street Address |
105 W STONE DR STE 5C |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-3365 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659374601 | Wendy Tipton Oberdick | Family Medicine | 105 W Stone Dr, Ste 1f, Kingsport, TN 37660-3365 | 2005-05-23 |
| 1235595919 | Everette Barton | Nurse Practitioner | 105 W Stone Dr, Ste 1j, Kingsport, TN 37660-3365 | 2016-01-11 |
| 1396118618 | Amy Galloway | Nurse Practitioner | 105 W Stone Dr, Ste 1f, Kingsport, TN 37660-3365 | 2015-11-09 |
| 1376928473 | Heather Harmon | Physical Therapist | 105 W Stone Dr, Ste 1d, Kingsport, TN 37660-3365 | 2015-07-30 |
| 1316322753 | Christina Danser | Nurse Practitioner | 105 W Stone Dr, Ste 1f, Kingsport, TN 37660-3365 | 2015-07-28 |
| 1679958995 | Wanda King | Nurse Practitioner | 105 W Stone Dr, Ste 4c, Kingsport, TN 37660-3365 | 2015-07-28 |
| 1538544473 | Lindsey Woodlief | Nurse Practitioner | 105 W Stone Dr, Ste 4c, Kingsport, TN 37660-3365 | 2015-07-21 |
| 1124414289 | Abram Arwood | Physical Therapist | 105 W Stone Dr, Ste 1d, Kingsport, TN 37660-3365 | 2015-04-15 |
| 1700204781 | Natasha Kanipe | Nurse Practitioner | 105 W Stone Dr, Ste 1f, Kingsport, TN 37660-3365 | 2014-04-07 |
| 1396187027 | Shane Adam Daniell | Physician Assistant | 105 W Stone Dr, Ste 3a, Kingsport, TN 37660-3365 | 2013-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
| 1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
| 1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
| 1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
| 1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
| 1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
| 1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| Find all providers in zip 37660 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356662027 | Jennifer Marie Crowley-rodig | Nurse Practitioner | 2002 Brookside Dr Ste 102, Kingsport, TN 37660-4634 | 2010-06-17 |
| 1629162227 | Cheri Denise Dickenson | Nurse Practitioner | 208 Lynn Garden Dr., Kingsport, TN 37660 | 2006-10-03 |
| 1669708848 | Wendy D Swiney | Nurse Practitioner | 105 W Stone Dr, Ste 1f, Kingsport, TN 37660-3256 | 2009-10-23 |
| 1326213398 | Cynthia L. Cloud | Nurse Practitioner | 2300 W Stone Dr, Kingsport, TN 37660-2360 | 2008-04-29 |
| 1689844375 | Jennifer R Wright | Nurse Practitioner | 111 W Stone Dr, Suite 200, Kingsport, TN 37660-6027 | 2008-03-10 |
| 1376575035 | Wellmont Cardiology Services | Nurse Practitioner | 2050 Meadowview Parkway, Kingsport, TN 37660-7332 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437757960 | Stephanie Cook | Nurse Practitioner | 8532 Wood Mills Dr W, Cordova, TN 38016-6169 | 2020-10-16 |
| 1245838713 | Rachel Goddard Claiborne | Nurse Practitioner | 7705 Poplar Ridge Dr, Nashville, TN 37221-2326 | 2020-10-15 |
| 1992303457 | Winnie Warun Kiri | Nurse Practitioner | 4715 Bonny Oaks Dr Apt 308, Chattanooga, TN 37416-3825 | 2020-10-15 |
| 1841807625 | Emily Marie Leidig | Nurse Practitioner | 271 Medical Park Blvd Fl 1, Bristol, TN 37620-7455 | 2020-09-25 |
| 1144831397 | Dana Lynn Marchetti | Nurse Practitioner | 113 Meadowvue Dr, Hendersonville, TN 37075-4212 | 2020-08-12 |
| 1770115925 | Lorne Avery Schwartz | Nurse Practitioner | 5606b Pennsylvania Ave, Nashville, TN 37209-1439 | 2020-02-05 |
| 1477196004 | Brie Lajeret | Nurse Practitioner | 800 Weatherly Dr Ste 201b, Clarksville, TN 37043-8958 | 2019-10-27 |
| 1851946560 | Virginia Elise Schlitt | Nurse Practitioner | 514 Crystal Springs Cir, Johnson City, TN 37615-2359 | 2019-08-08 |
| 1265991871 | Jane Holt | Nurse Practitioner | 647 Dunlop Ln Ste 101, Clarksville, TN 37040-5165 | 2019-03-14 |
| 1902378581 | Revital Health and Wellness Clinics Pllc | Nurse Practitioner | 695 President Pl Ste 200, Smyrna, TN 37167-5681 | 2018-12-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.