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General NPI Number Information
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NPI Number | 1275962912
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Entity Type | Individual
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Provider Name | MRS. ANNELISE BEADLE
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Gender | Female
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Dates
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Enumeration Date | 11/04/2013
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 1021 MOREHEAD MEDICAL DR
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City | CHARLOTTE
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State | NC
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Zip | 28204-2990
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Country | US
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Telephone | 980-442-7903
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Fax |
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Provider Business Mailing Address
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Address Line | 11344 DEER RIDGE LN
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City | CHARLOTTE
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State | NC
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Zip | 28277-1723
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P14478
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License Number State | NC
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