NICOLE S BEAVERS CPNP
NPI 1477685311
Nurse Practitioner - Pediatrics in Clinton, TN

Q: What is Nicole Beavers's NPI number?

The NPI number for Nicole Beavers is 1477685311. It was assigned to this individual provider in the NPPES registry on March 9, 2007. The provider is also known as Nicole Self Np.

Q: What is Nicole Beavers's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Beavers was last updated on July 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 09, 2007

2130 N. CHARLES SEIVERS BLVD, SUITE 4, CLINTON, TN 37716(865) 457-4044(866) 699-4833 Get Directions Write a Review

NPPES record last updated: July 8, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 8, 2025, Feb 12, 2025, Oct 3, 2022 and 4 more (7 updates tracked since 2019).

On this page

About Nicole S Beavers Cpnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE S BEAVERS CPNP (NPI 1477685311) is an individual pediatrics provider in Clinton, Tennessee, licensed in Tennessee (6963) and active in the NPI registry since March 2007. She maintains 3 additional practice locations.

NPPES Registry Identity

NPI1477685311

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameNICOLE S BEAVERSCredential: CPNP

Location Address2130 N. CHARLES SEIVERS BLVD, SUITE 4Clinton, TN 37716-6705

Mailing AddressPo Box 15004Knoxville, TN 37901-5004 · (865) 541-8895 · Fax (865) 633-4808

Phone(865) 457-4044

Fax(866) 699-4833

Sole ProprietorNo

Enumeration DateMarch 9, 2007

Last NPPES UpdateJuly 8, 20257 updates tracked since enumeration

NPPES CertifiedJuly 8, 2025

✔ NPI 1477685311 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in TN · 6963

2130 N. CHARLES SEIVERS BLVD, Clinton, TN 37716

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Other Names 1

Former Name (1)Nicole Self Np

Secondary Practice Locations 3

Location 12221 Jacksboro Pike Ste C4LA Follette, TN 37766-3007 · Phone (423) 566-3488 · Fax (866) 722-3453

Location 21705 Roane State HwyHarriman, TN 37748-8306 · Phone (865) 316-5001 · Fax (865) 376-3713

Location 3801 Oak Ridge TurnpikeOak Ridge, TN 37830-6916 · Phone (865) 482-4088 · Fax (866) 674-2033

Other Identifiers 1

MedicaidQ002695TN

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Beavers's NPI number?

The NPI number for Nicole Beavers is 1477685311. It was assigned to this individual provider in the NPPES registry on March 9, 2007. The provider is also known as Nicole Self Np.

Where is Nicole Beavers located?

Nicole Beavers practices at 2130 N. Charles Seivers Blvd Suite 4, Clinton, TN 37716. The listed phone number is (865) 457-4044.

What is Nicole Beavers's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

When was this NPI record last updated?

The NPPES record for Nicole Beavers was last updated on July 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.