MEDICARE: ADVANCED FIRST ASSISTANTS, LLC

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	367A00000X	Advanced Practice Midwife	RN051274	GA

General Provider Information

NPI Number	:	1215198965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED FIRST ASSISTANTS, LLC

Provider Business Mailing Address
First Line	:	2962 ROCKINGHAM DR NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-1231
Country	:	US
Telephone Number	:	404-376-1598
Fax Number	:	404-350-0937

Provider Business Practice Location Address
First Line	:	2962 ROCKINGHAM DR NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-1231
Country	:	US
Telephone Number	:	404-376-1598
Fax Number	:	404-350-0937

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEPHANIE BEASLEY
Credential	:
Telephone Number	:	404-376-1598

Provider Enumeration Date	:	06/24/2008
Last Update Date	:	06/24/2008

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