Provider Demographics
NPI:1073989752
Name:BEARD, DEANNA BROOKE (NP, PPCNP-BC)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:BROOKE
Last Name:BEARD
Suffix:
Gender:F
Credentials:NP, PPCNP-BC
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:BROOKE
Other - Last Name:HINKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, PPCNP-BC
Mailing Address - Street 1:51 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7327
Mailing Address - Country:US
Mailing Address - Phone:910-577-5199
Mailing Address - Fax:910-577-3424
Practice Address - Street 1:51 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7327
Practice Address - Country:US
Practice Address - Phone:910-577-5199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN73595-PPCNP-BC363LP0200X
NC5010057363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics