Organization
BEACON HEALTHCARE ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARQUITA TUCKER (MANAGER)
(601) 909-8006
Entity
Organization
Contact information
Practice address
5266 OLD HWY 11, SUITE 50 PMB 158, HATTIESBURG, MS 39402
(601) 909-8006
Mailing address
5266 OLD HWY 11, SUITE 50 PMB 158, HATTIESBURG, MS 39402
(601) 909-8006
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
09/27/2021
Last updated
10/04/2021
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