Provider Demographics
NPI:1053921080
Name:BEEVOR, JULIE (CNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BEEVOR
Suffix:
Gender:F
Credentials:CNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 WASHINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-3453
Mailing Address - Country:US
Mailing Address - Phone:218-444-8090
Mailing Address - Fax:218-333-9434
Practice Address - Street 1:1002 WASHINGTON AVE S
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-3453
Practice Address - Country:US
Practice Address - Phone:218-444-8090
Practice Address - Fax:218-333-9434
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2024-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7609363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health