Individual
JORDAN BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5670 PEACHTREE DUNWOODY RD STE 820, ATLANTA, GA 30342-4717
(404) 851-1998
Mailing address
1117 MAPLE RIDGE CT, EVANS, GA 30809-5249
(706) 836-0851
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN287126
GA
208200000X
Plastic Surgery Physician
RN287126
GA
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
RN287126
GA
363L00000X
Nurse Practitioner
Primary
RN287126
GA
363LA2100X
Acute Care Nurse Practitioner
RN287126
GA
Other
Enumeration date
10/16/2024
Last updated
01/28/2025
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