Individual
KENNISHA BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
113 CENTRAL AVE, HYDE PARK, MA 02136-3021
(617) 407-8682
Mailing address
113 CENTRAL AVE, HYDE PARK, MA 02136-3021
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN92700
MA
Other
Enumeration date
12/05/2025
Last updated
12/05/2025
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