Provider Demographics
NPI:1861493793
Name:BEASLEY, SHEILA FRANCINE (CRNA)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:FRANCINE
Last Name:BEASLEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:FRANCINE
Other - Last Name:HANER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1936 BROOKSIDE DR STE E
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4654
Mailing Address - Country:US
Mailing Address - Phone:423-765-0777
Mailing Address - Fax:423-765-0760
Practice Address - Street 1:400 N STATE OF FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6035
Practice Address - Country:US
Practice Address - Phone:423-431-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-005201367500000X
TN17971367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ031591Medicaid
TN103I431364OtherMEDICARE