Provider Demographics
NPI:1124563663
Name:BEAUFILS CONSULTING GROUP, LLC
Entity Type:Organization
Organization Name:BEAUFILS CONSULTING GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEAUFILS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN NP
Authorized Official - Phone:770-685-8494
Mailing Address - Street 1:109 S LEE ST
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-3709
Mailing Address - Country:US
Mailing Address - Phone:770-685-8494
Mailing Address - Fax:770-991-5012
Practice Address - Street 1:109 S LEE ST
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3709
Practice Address - Country:US
Practice Address - Phone:770-685-8494
Practice Address - Fax:770-991-5012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA194212363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty