Provider Demographics
NPI:1245042639
Name:BEALE, MEREDITH MEDORA (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:MEDORA
Last Name:BEALE
Suffix:
Gender:
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 S MAIN ST UNIT C
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-1712
Mailing Address - Country:US
Mailing Address - Phone:615-708-4950
Mailing Address - Fax:888-494-1676
Practice Address - Street 1:303 S MAIN ST UNIT C
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-1712
Practice Address - Country:US
Practice Address - Phone:615-708-4950
Practice Address - Fax:888-494-1676
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38199363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health