# MRS. ANNETTE DARLENE BEASLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1063504207
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01053156A | IN | — |
| 207Q00000X | Family Medicine Physician | 35785 | KY | Yes |

## Other

- **Enumeration date:** 09/28/2006
- **Last updated:** 09/03/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000292351 | ANTHEM | IN |
| 05 | — | 200357830A | — | IN |
| 01 | — | M400068689 | ANTHEM- ICC | KY |
| 01 | — | P00058122 | RAILROAD MEDICARE NUMBER | IN |