MEDICARE: JAKAI BEASLEY

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	376K00000X	Nurse's Aide	CN0030094623	GA

General Provider Information

NPI Number	:	1932042819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAKAI BEASLEY

Provider Business Mailing Address
First Line	:	1055 HOWELL MILL RD NW STE 800
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-5557
Country	:	US
Telephone Number	:	470-881-3193
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 HOWELL MILL RD NW STE 800
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-5557
Country	:	US
Telephone Number	:	470-881-3193
Fax Number	:	470-881-3126

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

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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