Provider Demographics
NPI:1760621254
Name:BEAMON-WEBB, NIKESIA (MD)
Entity Type:Individual
Prefix:DR
First Name:NIKESIA
Middle Name:
Last Name:BEAMON-WEBB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 INEZ OWENS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39212-3266
Mailing Address - Country:US
Mailing Address - Phone:601-502-1277
Mailing Address - Fax:601-372-2367
Practice Address - Street 1:3794 HIGHWAY 468 W
Practice Address - Street 2:
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-9008
Practice Address - Country:US
Practice Address - Phone:601-932-2880
Practice Address - Fax:601-932-3984
Is Sole Proprietor?:No
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS17637207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine