Individual
TIA BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
109 MULBERRY DR, TUPELO, MS 38801-6993
(662) 255-3008
Mailing address
109 MULBERRY DR, TUPELO, MS 38801-3175
(662) 255-3008
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00260
MS
Other
Enumeration date
12/30/2015
Last updated
11/03/2025
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