Individual
TRACY BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
851359
MS
363LA2200X
Adult Health Nurse Practitioner
AP129485
TX
363LG0600X
Gerontology Nurse Practitioner
851359
MS
363LP2300X
Primary Care Nurse Practitioner
Primary
851359
MS
Other
Enumeration date
04/27/2016
Last updated
01/09/2023
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