Individual
CASSIDY CONNETT BEALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1124 GALLERY PARK BLVD, WILMINGTON, NC 28412-1142
(910) 343-1031
(910) 251-8896
Mailing address
1202 MEDICAL CENTER DR, WILMINGTON, NC 28401-7307
(910) 617-6705
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
15743457
NC
363LF0000X
Family Nurse Practitioner
Primary
5017110
NC
363LF0000X
Family Nurse Practitioner
APN.0994155-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000171155
—
CO
Enumeration date
03/12/2019
Last updated
05/26/2023
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