Provider Demographics
NPI:1740779941
Name:BEARD, LEE ANN (FNP-C)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:ANN
Last Name:BEARD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 744786
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-4786
Mailing Address - Country:US
Mailing Address - Phone:704-834-2450
Mailing Address - Fax:704-671-5331
Practice Address - Street 1:105 ELM STREET
Practice Address - Street 2:
Practice Address - City:MCADENVILLE
Practice Address - State:NC
Practice Address - Zip Code:28101-0490
Practice Address - Country:US
Practice Address - Phone:704-824-5323
Practice Address - Fax:704-824-5410
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC197519363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily