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NPI Code Detail

MEDICARE: SHEILA FRANCINE BEASLEY CRNA

MEDICARE:   SHEILA FRANCINE BEASLEY  CRNA
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
1367500000XCertified Registered Nurse Anesthetist209-005201IL
2367500000XCertified Registered Nurse Anesthetist17971TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2103I431364OTHERTNMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861493793
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEILA FRANCINE BEASLEY CRNA
Provider Business Mailing Address
First Line : 1936 BROOKSIDE DR STE E
Second Line :
City : KINGSPORT
State : TN
Zip : 37660-4654
Country : US
Telephone Number : 423-765-0777
Fax Number : 423-765-0760
Provider Business Practice Location Address
First Line : 400 N STATE OF FRANKLIN RD
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-6035
Country : US
Telephone Number : 423-431-6111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 12/07/2022

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Directions to “ SHEILA FRANCINE BEASLEY CRNA” Practice Location

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