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

Wanda Renee Beaver

Individual provider Family Nurse Practitioner · NPI 1396160222

Wanda Renee Beaver is a Nurse Practitioner in Dyersburg, Tennessee. Qualified in 2014, 12 years ago. Practices with Healogics Specialty Physicians of Tennessee, PLLC, a 13-clinician group. Licensed in Tennessee.

Years since qualifying
12
Licensed in
TN
In the registry since
2014
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Practice location Address checks out

1999 Saint John Ave
Dyersburg, TN 38024-2117
Phone: (731) 286-1400
Fax: (731) 286-0109
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 18855 (TN)

Record details

NPI number1396160222
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 1, 2014
Last updated in NPPESMay 9, 2023
Certification dateMay 9, 2023
Mailing address1037 Roellen Newbern Rd, Dyersburg, TN 38024-7827

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Healogics Specialty Physicians Of Tennessee, Pllc — 13 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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