Provider Demographics
NPI:1376749036
Name:BEARDEN, CHARIS MERCER (RN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CHARIS
Middle Name:MERCER
Last Name:BEARDEN
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11149 RESEARCH BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5279
Mailing Address - Country:US
Mailing Address - Phone:512-231-1901
Mailing Address - Fax:512-231-1902
Practice Address - Street 1:11149 RESEARCH BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5279
Practice Address - Country:US
Practice Address - Phone:512-231-1901
Practice Address - Fax:512-231-1902
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX548917363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily