Doctor Name: | GAIL BEARD |
NPI Number: | 1003834052 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NNP |
License Number: | R612669 |
Business Practice Address: | 1730 14th Street Suite C Meridian, MS - 39301 |
Business Phone Number: | 6017039396 |
Business Fax Number: | |
Mailing Address: | 705 Waterview Dr, MERIDIAN |
State: | MS |
Postal Code: | 393075764 |
Phone Number: | 6014836459 |
Fax Number: | |
NPI Enumeration Date: | 07/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LN0005X |
License Number: | R612669 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Neonatal, Critical Care |
Taxonomy Definition: |