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NPI Code Detail

MEDICARE: TERA L BEAIRD PA-C

MEDICARE: TERA L BEAIRD 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
1363A00000XPhysician Assistant2022009849MO

General Provider Information

NPI Number : 1841261195
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERA L BEAIRD PA-C
Provider Business Mailing Address
First Line : PO BOX 802843
Second Line :
City : KANSAS CITY
State : MO
Zip : 64180-2843
Country : US
Telephone Number : 417-730-6430
Fax Number : 417-269-7567
Provider Business Practice Location Address
First Line : 1150 STATE HIGHTWAY 248
Second Line : STE 200
City : BRANSON
State : MO
Zip : 65616-4186
Country : US
Telephone Number : 417-336-4112
Fax Number : 417-335-4684
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2006
Last Update Date : 04/12/2022

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Directions to “ TERA L BEAIRD PA-C” Practice Location

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