Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Beverly J Provo, GNPC

Individual provider Adult Health Nurse Practitioner · NPI 1215096482

Beverly J Provo, GNPC is an Adult Health Nurse Practitioner in Newark, New York. Licensed in New York. Registered with an NPI since 2006.

Licensed in
NY
In the registry since
2006
Specialties on file
2

Practice location Address checks out

1208 Driving Park Ave
Newark, NY 14513-1057
Phone: (315) 359-2640
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence F3403661 (NY)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence F3041711 (NY)

Record details

NPI number1215096482
Entity typeIndividual (Type 1)
GenderFemale
Credentials GNPC
Sole proprietorNo
NPI enumeratedDecember 6, 2006
Last updated in NPPESJanuary 6, 2011
Mailing address1208 Driving Park Ave, Newark, NY 14513-1057

Other providers in Newark