Provider Demographics
NPI:1023283165
Name:BEARD, JONI MICHELLE
Entity type:Individual
Prefix:
First Name:JONI
Middle Name:MICHELLE
Last Name:BEARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 ELM ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-5437
Mailing Address - Country:US
Mailing Address - Phone:785-840-5898
Mailing Address - Fax:785-856-0127
Practice Address - Street 1:827 ELM ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-5437
Practice Address - Country:US
Practice Address - Phone:785-840-5898
Practice Address - Fax:785-856-0127
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator