Provider Demographics
NPI:1477217495
Name:BEALL, MIKAYLIN R (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MIKAYLIN
Middle Name:R
Last Name:BEALL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27343 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-7519
Mailing Address - Country:US
Mailing Address - Phone:724-714-5506
Mailing Address - Fax:
Practice Address - Street 1:13168 MEADOWVIEW SQUARE
Practice Address - Street 2:
Practice Address - City:MEADOWVIEW
Practice Address - State:VA
Practice Address - Zip Code:24361
Practice Address - Country:US
Practice Address - Phone:276-944-3999
Practice Address - Fax:276-944-3882
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202198341835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care