Provider Demographics
NPI:1558726893
Name:BEASON, SHARON (RN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:BEASON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9659 COUNTY ROAD 25
Mailing Address - Street 2:
Mailing Address - City:HEFLIN
Mailing Address - State:AL
Mailing Address - Zip Code:36264-4448
Mailing Address - Country:US
Mailing Address - Phone:256-419-1604
Mailing Address - Fax:
Practice Address - Street 1:9659 COUNTY ROAD 25
Practice Address - Street 2:
Practice Address - City:HEFLIN
Practice Address - State:AL
Practice Address - Zip Code:36264-4448
Practice Address - Country:US
Practice Address - Phone:256-419-1604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN194926163W00000X
AL1-100207163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse