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Deactivated NPI 1770717068 Deactivated / Inactive NPI Female Practitioner

Beverly A Jeannette , HIS

Specialist • Crivitz, WI

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Beverly Jeannette has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 14, 2009
NPI Deactivation Date September 09, 2022
Total Practice Duration ~13 Years of Practice (2009 – 2022)

Professional Overview & Biography Verified Profile Summary

Beverly Jeannette, HIS was a registered Specialist practicing in Crivitz, WI. Throughout an active medical career spanning 13 years, Beverly Jeannette provided care at the practice location at 117 N HWY 141 until profile deactivation on 2022-09-09.

Practice Location & Contact Primary Location

Practice Address

117 N Hwy 141
Suite 104

Crivitz, WI 541141686

Telephone 7158543432
Fax 9067899539

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Crivitz, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 36.3 Yrs
Regional Practice Density
1 Specialists

Practicing in Crivitz, WI (312 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License WI WI1066

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 09, 2022

Record deactivated on September 09, 2022

NPI Profile Active May 14, 2009

NPI status registered as active in NPPES database

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Updated Practice Location May 14, 2009

Registered at 117 N HWY 141, SUITE 104, CRIVITZ, WI 541141686 (Tel: 7158543432)

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Updated Business Mailing Address May 14, 2009

Registered at 1620 WILLOW CREEK RD LOT 3, ESCANABA, MI 498294328 (Tel: 9067899539)

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Provider Name / Credentials Updated May 14, 2009

Recorded as BEVERLY JEANNETTE, HIS

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 14, 2009

Specialist (License #WI1066 in WI)

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Initial NPI Registration & Enumeration May 14, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1770717068
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 14, 2009
Last Update: May 14, 2009
Deactivation Date: September 09, 2022

Mailing Address

1620 Willow Creek Rd Lot 3

Escanaba, MI 498294328

Phone: 9067899539

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.