BEVERLY TIPPENS QUENNEVILLE (NPI# 1851308589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851308589 |
| Entity Type | Individual |
| Full Name | BEVERLY TIPPENS QUENNEVILLE |
| Other Name | BEVERLY F. TIPPENS |
| Credential | PA-C |
| Practice Address |
530 Fontaine St Pensacola FL 32503 |
| Mailing Address |
801 York St Manitowoc WI 54220-4630 |
| Practice Telephone | 8002437546 |
| Practice Fax Number | 8504848223 |
| Mailing Telephone | 9206639008 |
| Mailing Fax Number | 9206841439 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2019-11-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9103191 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 292339400 | 05 | |
| FL | BLUE CROSS BLUE SHIELD | Y0K2N | 01 |
| AL | BLUE CROSS BLUE SHIELD | 591-89444 | 01 |
| AL | BLUE CROSS BLUE SHIELD | 592-27571 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1200 Gulf Breeze Pkwy Ste A, Gulf Breeze, FL 325614855 | 8002437546 | 8504848223 |
| 540 Fontaine St, Pensacola, FL 325032019 | 8504744775 | 8504848223 |
| Street Address |
530 FONTAINE ST |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376536508 | William B Henghold II | Dermatology | 530 Fontaine St, Pensacola, FL 32503-2019 | 2005-08-23 |
| 1083259642 | Forefront Dermatology, S.c. | Dermatology | 530 Fontaine St, Pensacola, FL 32503-2019 | 2019-11-07 |
| 1164814547 | Patrizia Angela Lewis | Nurse Practitioner | 530 Fontaine St, Pensacola, FL 32503-2019 | 2015-02-23 |
| 1699115014 | Luke Hyder | Dermatology | 530 Fontaine St, Pensacola, FL 32503-2019 | 2013-06-29 |
| 1760724314 | Henghold Surgery Center LLC | Clinic/Center | 530 Fontaine St, Pensacola, FL 32503-2019 | 2013-03-21 |
| 1861666398 | Jeanette Nadine Batchelor | Physician Assistant | 530 Fontaine St, Pensacola, FL 32503-2019 | 2008-04-16 |
| 1598877953 | Kelly Christine Stubblefield | Nurse Practitioner | 530 Fontaine St, Pensacola, FL 32503 | 2006-08-31 |
| 1306850797 | Jerome Paul Fairchild | Dermatology | 530 Fontaine St, Pensacola, FL 32503-2019 | 2006-07-28 |
| 1770519647 | Debra Martin Cole | Physician Assistant | 530 Fontaine St, Pensacola, FL 32503-2019 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134727472 | Lauren Barrett Evans | Nurse Practitioner | 4700 Bayou Boulevard, Suite 6, Pensacola, FL 32503 | 2020-10-09 |
| 1528666864 | Kelsey Christine Kvartek | Nurse Practitioner | 4700 Bayou Blvd., Suite 6, Pensacola, FL 32503 | 2020-10-09 |
| 1730790551 | Sacred Heart Hospital of Pensacola | Podiatrist | 1890 Summit Blvd, Pensacola, FL 32503 | 2020-08-14 |
| 1891312815 | Sacred Heart Asc, LLC | Clinic/Center | 1890 Summit Boulevard, Suite 210, Pensacola, FL 32503 | 2020-06-26 |
| 1275011744 | Teresa T Jansen | Registered Nurse | 5051 Carpenters Creek Dr, Pensacola, FL 32503 | 2018-08-06 |
| 1639662729 | Florida Physical Therapy Services of Pensacola, LLC | Occupational Therapist | 428 Airport Blvd, Pensacola, FL 32503 | 2018-06-13 |
| 1922595123 | Touch of Love Home Health Care LLC | Home Health | 139 E Burgess Rd Ste B, Pensacola, FL 32503 | 2018-04-13 |
| 1770012106 | Amber Mcclellan | Occupational Therapist | 4551 North Davis Highway, Suite C, Pensacola, FL 32503 | 2017-06-08 |
| 1780123885 | Corinne Georgette-marie Carlson | Registered Nurse | 6809 White Oak Drive, Pensacola, FL 32503 | 2017-02-22 |
| 1538615232 | Kristin E Patton | Dietitian, Registered | 4501 North Davis Hwy, Suite C, Pensacola, FL 32503 | 2016-09-01 |
| Find all providers in zip 32503 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558716811 | Physician Associates of The Palm Beaches | Physician Assistant | 49 Skystone Ct, Pensacola, FL 32506-6842 | 2016-04-24 |
| 1548690936 | Pensacola House Calls,llc | Physician Assistant | 5040 Yesteroaks Cir, Pensacola, FL 32504-4316 | 2013-11-21 |
| 1508146796 | Whitney Cronenberg Hunter | Physician Assistant | 545 Brent Lane, Pensacola, FL 32503 | 2011-08-19 |
| 1326244146 | Jessica Aurelio Samson | Physician Assistant | 8141 Westbourne Dr, Pensacola, FL 32506-4959 | 2007-06-27 |
| 1437204948 | Jessie Enrique Gross | Physician Assistant | 220 Hovey Rd Fl 1047, Pensacola, FL 32508-1047 | 2007-01-24 |
| 1689760894 | Mamie Yuk-ming Wu | Physician Assistant | 4511 N Davis Hwy Ste C-1, Pensacola, FL 32503-2734 | 2006-10-05 |
| 1437138344 | Daniel Carl Brunner | Physician Assistant | 9400 University Pkwy Ste 401a, Pensacola, FL 32514-5485 | 2006-01-10 |
| 1558346213 | Angela B Bray | Physician Assistant | 8596 Orange Avenue, Pensacola, FL 32534 | 2005-12-14 |
| 1225635329 | Adam James Crowson | Physician Assistant | 5115 N Palafox St, Pensacola, FL 32505-2932 | 2020-10-02 |
| 1992320881 | Access To Care, P.a. | Physician Assistant | 1010 N 12th Ave Ste 125, Pensacola, FL 32501-3315 | 2020-06-16 |
| Find all providers in PENSACOLA | ||||
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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.