Individual
MRS. STEPHANIE MICHELLE BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
724 LEIGH DR, COLUMBUS, MS 39705-3098
(662) 328-3375
(662) 328-3395
Mailing address
724 LEIGH DR, COLUMBUS, MS 39705-3098
(662) 328-3375
(662) 328-3395
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R855599
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00188819
—
MS
Enumeration date
09/08/2010
Last updated
12/16/2021
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