Provider Demographics
NPI:1659953586
Name:B BEARDSLEY ARNP, PLLC
Entity Type:Organization
Organization Name:B BEARDSLEY ARNP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:BEARDSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:904-321-9875
Mailing Address - Street 1:12058 SAN JOSE BLVD STE 1003
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-8667
Mailing Address - Country:US
Mailing Address - Phone:904-321-9875
Mailing Address - Fax:904-321-9890
Practice Address - Street 1:12058 SAN JOSE BLVD STE 1003
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8667
Practice Address - Country:US
Practice Address - Phone:904-321-9875
Practice Address - Fax:904-321-9890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty