Provider Demographics
NPI:1952829731
Name:BEAMS, KRISTY LEE (PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:LEE
Last Name:BEAMS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12443 SAN JOSE BLVD STE 604
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-8652
Mailing Address - Country:US
Mailing Address - Phone:561-266-8866
Mailing Address - Fax:561-404-4735
Practice Address - Street 1:12443 SAN JOSE BLVD STE 604
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8652
Practice Address - Country:US
Practice Address - Phone:561-266-8866
Practice Address - Fax:561-404-4735
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-31
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9203802363LF0000X
FLARNP9203802363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2023033477OtherAMERICAN NURSE CREDENTIALING CENTER