Provider Demographics
NPI:1134827629
Name:BESHEARS, FELICIA MARIE
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:MARIE
Last Name:BESHEARS
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 1:5587 GLADESVILLE RD LOT 24
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:WV
Mailing Address - Zip Code:26374-8496
Mailing Address - Country:US
Mailing Address - Phone:304-212-1951
Mailing Address - Fax:
Practice Address - Street 1:5587 GLADESVILLE RD LOT 24
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:WV
Practice Address - Zip Code:26374-8496
Practice Address - Country:US
Practice Address - Phone:304-212-1951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant