Provider Demographics
NPI:1134242019
Name:BEALL, FRANCES E
Entity type:Individual
Prefix:MRS
First Name:FRANCES
Middle Name:E
Last Name:BEALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FRANCES
Other - Middle Name:MARGARET
Other - Last Name:EICHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55 CARLTON ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30602-1503
Mailing Address - Country:US
Mailing Address - Phone:706-542-8621
Mailing Address - Fax:
Practice Address - Street 1:55 CARLTON ST
Practice Address - Street 2:UNIVERSITY HEALTH CENTER
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30602-1503
Practice Address - Country:US
Practice Address - Phone:706-542-8654
Practice Address - Fax:706-542-0275
Is Sole Proprietor?:No
Enumeration Date:2007-04-07
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN040301363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00647842AMedicaid