Healthcare Provider Details

I. General information

NPI: 1235324427
Provider Name (Legal Business Name): JAMI L BEASLEY NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2007
Last Update Date: 04/14/2026
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 S NATIONAL AVE DIV PED NEWBORN MEDCINE, STE G800
SPRINGFIELD MO
65807-5210
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-7728
  • Fax: 417-269-4608
Mailing address:
  • Phone: 417-269-7728
  • Fax: 417-269-4608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2002018099
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: