MEDICARE: JENNA BEEBE PA-C

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	363AM0700X	Medical Physician Assistant	001015787	NC

General Provider Information

NPI Number	:	1780540682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA BEEBE PA-C

Provider Business Mailing Address
First Line	:	143 LANGTREE SHORE DR APT 201
Second Line	:
City	:	MOORESVILLE
State	:	NC
Zip	:	28117-8736
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1405 FERN CREEK DR
Second Line	:
City	:	STATESVILLE
State	:	NC
Zip	:	28625-9376
Country	:	US
Telephone Number	:	704-659-7866
Fax Number	:	877-881-8455

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/12/2026

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