Provider Demographics
NPI:1346690666
Name:BEASLEY, KYLA MARIE BERRIER (RN, NP, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:KYLA
Middle Name:MARIE BERRIER
Last Name:BEASLEY
Suffix:
Gender:F
Credentials:RN, NP, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 GUS LN
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-8628
Mailing Address - Country:US
Mailing Address - Phone:321-427-6093
Mailing Address - Fax:
Practice Address - Street 1:703 NEWMAN RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5239
Practice Address - Country:US
Practice Address - Phone:321-427-6093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9361943363LP0200X
NC312374363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics