Individual
KERRY A BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D
Contact information
Practice address
77 W FOREST AVE STE 212, FLAGSTAFF, AZ 86001-1481
(928) 773-2222
(928) 773-2287
Mailing address
PO BOX 31210, FLAGSTAFF, AZ 86003-1210
(928) 773-2222
(928) 773-2598
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
DA10277
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053853945
UHC
AZ
05
—
213468
—
AZ
01
—
Z196468
MEDICARE
AZ
Enumeration date
11/09/2016
Last updated
10/12/2020
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