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Contact Information

NICOLE S BEAVERS, CPNP
2130 N. CHARLES SEIVERS BLVD
SUITE 4
CLINTON, TN37716-6705
 Phone: 865-457-4044
 Fax: 866-699-4833
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

363LP0200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for NICOLE S BEAVERS · (Female)

NPI # 1477685311
Status Active
Credentials CPNP (Certified Pediatric Nurse Practitioner)
Entity Individual
Enumeration date 03/09/2007
Last updated 07/08/2025 - About 11 months ago
Sole proprietor 1 No
Identifiers
  • TN License # 6963
  • TN Medicaid Q002695
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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