Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 2002018099 | MO |
NPI | 1235324427 |
---|---|
Provider Name | Jami Lyn Beasley |
First Address | Kansas City, MO 64180-2843 |
Second Address | Springfield, MO 65807-5210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2007 |
Last Update Date | 05/05/2020 |