Individual
MRS. THERESA BEARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNFA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
R857458
MS
Other
Enumeration date
12/16/2009
Last updated
11/19/2014
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