Individual
MANDI DAWN BEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4515 PREMIER DR STE 204, HIGH POINT, NC 27265-8356
(336) 802-2075
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-1331
(336) 716-3202
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
287553
NC
363L00000X
Nurse Practitioner
Primary
5015933
NC
363LF0000X
Family Nurse Practitioner
5015933
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021184815
ANCC FNP
NC
Enumeration date
03/14/2022
Last updated
04/25/2022
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