MEDICARE: KRISTY MICHELLE BEAMON PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA-478	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972869592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTY MICHELLE BEAMON PA

Provider Business Mailing Address
First Line	:	147 SECTION LINE RD STE G
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6188
Country	:	US
Telephone Number	:	281-429-8522
Fax Number	:	907-600-2610

Provider Business Practice Location Address
First Line	:	147 SECTION LINE RD STE G
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6188
Country	:	US
Telephone Number	:	281-429-8522
Fax Number	:	907-600-2610

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2012
Last Update Date	:	09/30/2025

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