Individual
LACEY J BEASTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1320 KELLY ST, OCEANSIDE, CA 92054-6412
(760) 717-5770
Mailing address
1320 KELLY ST, OCEANSIDE, CA 92054-6412
(760) 717-5770
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
95017474
CA
Other
Enumeration date
08/20/2021
Last updated
08/20/2021
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