Individual
MR. ETHAN BEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN FNP-C
Contact information
Practice address
740 S LIMESTONE STE L104, LEXINGTON, KY 40536-1991
(859) 257-3253
(859) 323-1203
Mailing address
2620 ELM HILL PIKE, NASHVILLE, TN 37214-3108
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3016193
KY
Other
Enumeration date
06/08/2021
Last updated
09/16/2022
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