Provider Demographics
NPI:1740580844
Name:BEASLEY, CHARITY HOPE
Entity Type:Individual
Prefix:MRS
First Name:CHARITY
Middle Name:HOPE
Last Name:BEASLEY
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 1:1090 OLD FLORENCE ROAD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464
Mailing Address - Country:US
Mailing Address - Phone:931-762-6505
Mailing Address - Fax:931-762-3690
Practice Address - Street 1:1090 OLD FLORENCE ROAD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464
Practice Address - Country:US
Practice Address - Phone:931-762-6505
Practice Address - Fax:931-762-3690
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator