Provider Demographics
NPI:1477158699
Name:BEALS, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:BEALS
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 1:1800 HOWELL MILL RD NW STE 800
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-0922
Mailing Address - Country:US
Mailing Address - Phone:404-350-9853
Mailing Address - Fax:
Practice Address - Street 1:1800 HOWELL MILL RD NW STE 800
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-0922
Practice Address - Country:US
Practice Address - Phone:404-350-9853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN154824163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WX0200XNursing Service ProvidersRegistered NurseOncologyGroup - Single Specialty