Provider Demographics
NPI:1922765734
Name:BEASON, SARAH WEBB (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:WEBB
Last Name:BEASON
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1746 WESTCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37803-6300
Mailing Address - Country:US
Mailing Address - Phone:865-266-3109
Mailing Address - Fax:
Practice Address - Street 1:2001 LAUREL AVE STE 304
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1834
Practice Address - Country:US
Practice Address - Phone:865-266-3109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29440363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care