| NPI | 1154715662 |
|---|---|
| Former Name | KIMBERLY BEASLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: AL 1-131123) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AL 1-131123) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2023-06-30 |