Individual
EMILY WADE BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9263 MEDICAL PLAZA DR, STE E, CHARLESTON, SC 29406-7109
(843) 572-1228
(843) 576-6168
Mailing address
9263 MEDICAL PLAZA DR, STE E, CHARLESTON, SC 29406-7109
(843) 572-1228
(843) 576-6168
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
19217
SC
390200000X
Student in an Organized Health Care Education/Training Program
103623
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN2416
—
SC
Enumeration date
11/05/2014
Last updated
02/04/2016
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