Terry, Heather Beasley
Terry, Heather Beasley is an individual health care provider with primary practice located at 2785 Lawrenceville Hwy Suite100, Decatur GA 30033-2515. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Terry, Heather Beasley can be contacted via phone (404) 292-4612.Contact Information
Primary practice address
2785 Lawrenceville Hwy Suite100
Decatur GA 30033-2515
Phone: (404) 292-4612
Fax: (678) 514-0088
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 003743 | Georgia |
Profile Details
| NPI number | 1578507612 |
|---|---|
| LBN Legal business name | Terry, Heather Beasley |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2006 |
| Last updated | Aug 25th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578507612 | NPPES |
| Georgia | MEDICAID | 100002705A |
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