MEDICARE: ELECTRA K BEARD FNP-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	363LF0000X	Family Nurse Practitioner	908088	MS
2	363LF0000X	Family Nurse Practitioner	40445	TN

General Provider Information

NPI Number	:	1801766936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELECTRA K BEARD FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 376
Second Line	:
City	:	OLIVE BRANCH
State	:	MS
Zip	:	38654-0376
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 376
Second Line	:
City	:	OLIVE BRANCH
State	:	MS
Zip	:	38654-0376
Country	:	US
Telephone Number	:	901-515-8522
Fax Number	:

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

Provider Enumeration Date	:	11/05/2025
Last Update Date	:	02/25/2026

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Directions to “ ELECTRA K BEARD FNP-C” Practice Location

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