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

Mrs. Beverly Jane Waddell, ANP, GCNS

Individual provider Gerontology Clinical Nurse Specialist · NPI 1811161813

Mrs. Beverly Jane Waddell, ANP, GCNS is a Nurse Practitioner in Kingsport, Tennessee. Qualified in 2007, 19 years ago. Practices with Holston Medical Group PC, a 242-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
19
Licensed in
TN
In the registry since
2008
Specialties on file
3

Practice location Address checks out

105 W Stone Dr Ste 5C
Kingsport, TN 37660-3365
Phone: (423) 378-7645
Fax: (423) 392-3863
Show map & directions

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

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence APN13413 (TN)
Gerontology Clinical Nurse Specialist Taxonomy 364SG0600X · Licence 13413 (TN)
Registered Nurse Taxonomy 163W00000X · Licence RN129155 (TN)

Record details

NPI number1811161813
Entity typeIndividual (Type 1)
GenderFemale
Credentials ANP , GCNS
Sole proprietorNo
NPI enumeratedApril 22, 2008
Last updated in NPPESNovember 18, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Holston Medical Group Pc — 242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare