Healthcare Provider Details

I. General information

NPI: 1689003873
Provider Name (Legal Business Name): SARAH BEASLEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 LAKELAND DR SUITE 750
JACKSON MS
39216-4643
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 601-200-5955
  • Fax: 601-200-5929
Mailing address:
  • Phone: 601-200-4970
  • Fax: 225-765-4278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number871435
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: