Provider Demographics
NPI:1518324912
Name:BEASLEY, KRISTEN BETH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:BETH
Last Name:BEASLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 HIGHWAY 51 S
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38063-4580
Mailing Address - Country:US
Mailing Address - Phone:731-635-8189
Mailing Address - Fax:731-635-8126
Practice Address - Street 1:79 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-4580
Practice Address - Country:US
Practice Address - Phone:731-635-8189
Practice Address - Fax:731-635-8126
Is Sole Proprietor?:No
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20870363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily