| Doctor Name: | MS. LAURIE JEAN BEAVERS |
| NPI Number: | 1386747343 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FAMILY NURSE PRACTIT |
| License Number: | 209 000817 |
| Business Practice Address: | 8590 Saint Lukes Dr Beardstown, IL - 626188398 |
| Business Phone Number: | 2173232242 |
| Business Fax Number: | 2174527245 |
| Mailing Address: | Rr 1 Box 130, GREENFIELD |
| State: | IL |
| Postal Code: | 62044 |
| Phone Number: | 2173683001 |
| Fax Number: | |
| NPI Enumeration Date: | 09/06/2006 |
| NPI Last Update Date: | 09/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 209 000817 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |