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General NPI Number Information
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NPI Number | 1316827504
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Entity Type | Organization
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Legal Business Name | BEELINE HEALTH, PLLC
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Dates
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Enumeration Date | 09/06/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 305 W RUSK ST
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City | JACKSONVILLE
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State | TX
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Zip | 75766-2337
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Country | US
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Telephone | 903-721-0112
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Fax |
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Provider Business Mailing Address
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Address Line | 305 W RUSK ST
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City | JACKSONVILLE
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State | TX
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Zip | 75766-2337
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Country | US
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Telephone | 903-393-3594
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Fax |
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Authorized Official
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Title or Position | OWNER/FAMILY NURSE PRACTITIONER
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Name | BERYL THOMPSON
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Credential | FNP
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Telephone | 903-393-3594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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