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Individual

MS. PATRICIA K BEASLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, RD, LDN, CCN

Contact information

Practice address
5270 SIX FORKS RD, RALEIGH, NC 27609-4432
(919) 782-4181
Mailing address
5270 SIX FORKS RD, RALEIGH, NC 27609-4432
(919) 782-4181

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L000937
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
144CC
BCBSNC PROVIDER #
NC
Enumeration date
02/17/2007
Last updated
07/08/2007
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