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NPI Code Detail

MEDICARE: BEELINE NEURO, LLC

MEDICARE: BEELINE NEURO, 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
1363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1831051705
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEELINE NEURO, LLC
Provider Business Mailing Address
First Line : 3900 WESTERRE PKWY STE 300
Second Line :
City : RICHMOND
State : VA
Zip : 23233-1339
Country : US
Telephone Number : 804-578-7442
Fax Number : 804-215-0454
Provider Business Practice Location Address
First Line : 3900 WESTERRE PKWY STE 300
Second Line :
City : RICHMOND
State : VA
Zip : 23233-1339
Country : US
Telephone Number : 804-578-7442
Fax Number : 804-215-0454
Authorized Official
Title or Position : CEO/NURSE PRACTITIONER
Name : MRS. REBECCA ANN FARRELL GRINSELL
Credential : MSN, APRN, FNP-C
Telephone Number : 804-578-7442
Provider Enumeration Date : 12/01/2025
Last Update Date : 12/01/2025

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Directions to “BEELINE NEURO, LLC ” Practice Location

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