Individual
KAITLIN M BEADLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9305 W THOMAS RD STE 370, PHOENIX, AZ 85037-3367
(602) 266-5678
(602) 264-5646
Mailing address
645 E MISSOURI AVE STE 280, PHOENIX, AZ 85012-1349
(602) 264-9100
(602) 264-9101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8161
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156602
—
AZ
01
—
Z120390
PTAN
AZ
Enumeration date
07/06/2020
Last updated
09/18/2023
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