| NPI | 1548605769 |
|---|---|
| Former Name | JESSICA NICOLE BEARDEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TX R7710) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX R7710) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2025-04-28 |