Provider Demographics
NPI:1790576783
Name:BEASLEY, JUANYETTA (RN)
Entity type:Individual
Prefix:DR
First Name:JUANYETTA
Middle Name:
Last Name:BEASLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8041 BRIER CREEK PKWY # 1083
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-7596
Mailing Address - Country:US
Mailing Address - Phone:919-637-6865
Mailing Address - Fax:
Practice Address - Street 1:1420 SPRINGSHIRE CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-2561
Practice Address - Country:US
Practice Address - Phone:984-381-6313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC189613163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health