Provider Demographics
NPI:1417728478
Name:PEARSON, BEAURIE
Entity Type:Individual
Prefix:
First Name:BEAURIE
Middle Name:
Last Name:PEARSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9403 BETHUNE DR
Mailing Address - Street 2:
Mailing Address - City:THONOTOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:33592-2129
Mailing Address - Country:US
Mailing Address - Phone:813-541-5945
Mailing Address - Fax:
Practice Address - Street 1:9403 BETHUNE DR
Practice Address - Street 2:
Practice Address - City:THONOTOSASSA
Practice Address - State:FL
Practice Address - Zip Code:33592-2129
Practice Address - Country:US
Practice Address - Phone:813-541-5945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No376J00000XNursing Service Related ProvidersHomemaker