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NPI Code Detail

MEDICARE: MRS. RENA R BEAL RN, MSN, CFNP

MEDICARE: MRS. RENA R BEAL RN, MSN, CFNP
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 PractitionerR789853MS
2363LF0000XFamily Nurse PractitionerAPRN.CNP.0037872OH

General Provider Information

NPI Number : 1942372412
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RENA R BEAL RN, MSN, CFNP
Provider Business Mailing Address
First Line : 568 N PARK LN
Second Line :
City : JACKSON
State : MS
Zip : 39206-3815
Country : US
Telephone Number : 601-362-4471
Fax Number : 601-982-4351
Provider Business Practice Location Address
First Line : 500 MADISON AVE STE 200
Second Line :
City : TOLEDO
State : OH
Zip : 43604-1230
Country : US
Telephone Number : 567-312-8700
Fax Number : 567-312-8793
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 01/02/2025

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