Provider Demographics
NPI:1649076803
Name:BEASLEY, MEKHIA MONAE
Entity type:Individual
Prefix:
First Name:MEKHIA
Middle Name:MONAE
Last Name:BEASLEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3318 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-1319
Mailing Address - Country:US
Mailing Address - Phone:402-779-6108
Mailing Address - Fax:
Practice Address - Street 1:3031 BLONDO ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-4181
Practice Address - Country:US
Practice Address - Phone:402-779-6108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider