LESA BEAVER (NPI# 1861680670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861680670 |
| Entity Type | Individual |
| Full Name | LESA BEAVER |
| Credential | NP |
| Practice Address |
7751 Wolf River Blvd Germantown TN 38138-1706 |
| Practice Telephone | 9012974000 |
| Practice Fax Number | 9015318444 |
| Mailing Telephone | 9012974000 |
| Mailing Fax Number | 9015318444 |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2018-01-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
APN0000008070 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN0000127593 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7751 WOLF RIVER BLVD |
| City | GERMANTOWN |
| State | TN |
| Zip Code | 38138-1706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700973625 | Proactive Heart & Vascular, Pllc | Internal Medicine | 7751 Wolf River Blvd, Germantown, TN 38138-1706 | 2006-10-10 |
| 1215470489 | Angela Prieb Hamilton | Nurse Practitioner | 7751 Wolf River Blvd, Germantown, TN 38138-1706 | 2016-11-21 |
| 1043477136 | Michael Aaron Nelson | Internal Medicine | 7751 Wolf River Blvd, Germantown, TN 38138-1706 | 2008-05-17 |
| 1104968171 | Tracie L. Luther | Nurse Practitioner | 7751 Wolf River Blvd, Germantown, TN 38138 | 2007-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790382281 | Bluff Medical Group | Nurse Practitioner | 1779 Kirby Parkway, Suite 1-212, Germantown, TN 38138 | 2020-10-07 |
| 1689293797 | Diana Bryn Manning | Dietitian, Registered | 7705 Poplar Ave., Medical Office B, Suite 150, Germantown, TN 38138 | 2020-04-09 |
| 1386102796 | Moscow Group LLC | Pharmacy | 2013 Exeter Rd, Germantown, TN 38138 | 2019-03-05 |
| 1952811010 | Select | Counselor | 9045 Forest Centre Dr Ste 102, Germantown, TN 38138 | 2017-10-03 |
| 1033638994 | 901 Physical Therapy, Pllc | Physical Therapist | 2495 Regents Walk, Germantown, TN 38138 | 2017-09-12 |
| 1124552401 | Elite Dental Germantown Plc | Dentist | 9064 Corporate Gradens Drive, Germantown, TN 38138 | 2017-04-13 |
| 1740728880 | Christian C Haynes | Nurse Anesthetist, Certified Registered | 1900 Exeter Rd., Suite 210, Germantown, TN 38138 | 2017-02-09 |
| 1740644004 | Kimberly Brooke Scheidegger | Counselor | 9045 Forest Centre Way, Heartlife Professional Soul Care, Germantown, TN 38138 | 2016-04-12 |
| 1427411644 | Jimmy Tam Tran | Internal Medicine | 7550 Wolf River Blvd., Ste. 102, Germantown, TN 38138 | 2016-04-04 |
| 1952761876 | Jane Chin Wynn Yeoh | Orthopaedic Surgery | 1400 South Germantown Road, Germantown, TN 38138 | 2016-03-04 |
| Find all providers in zip 38138 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518500123 | Marybeth Trutko Stockman | Nurse Practitioner | 18928 Liberty Mill Rd, Germantown, MD 20874-1414 | 2019-10-26 |
| 1760428239 | Cheryl Jane Spritzer | Nurse Practitioner | 12429 Milestone Center Drive, Suite 200, Germantown, MD 20876-0299 | 2006-06-21 |
| 1104435148 | Jeannette Marie Gomez | Nurse Practitioner | 7691 Poplar Ave, Germantown, TN 38138-3904 | 2020-07-27 |
| 1477199354 | Andrew Connor Ragin | Nurse Practitioner | 7460 Wolf River Blvd, Germantown, TN 38138-1760 | 2019-11-26 |
| 1043793896 | Lindsay Mikaela Barton | Nurse Practitioner | 7600 Wolf River Blvd, Germantown, TN 38138 | 2018-09-07 |
| 1194205823 | Kimala Moseby-fowler | Nurse Practitioner | 7691 Poplar Ave, Germantown, TN 38138 | 2018-08-21 |
| 1497204911 | Deiadra Brown | Nurse Practitioner | 7460 Wolf River Blvd, Germantown, TN 38138-1760 | 2016-09-26 |
| 1487109773 | Jena Parker Willis | Nurse Practitioner | 8060 Wolf River Blvd, Germantown, TN 38138-1727 | 2016-08-17 |
| 1487059143 | Veronica Crowell | Nurse Practitioner | 7691 Poplar Ave, Germantown, TN 38138-3904 | 2014-10-23 |
| 1023357860 | Cynthia Denise Bedford | Nurse Practitioner | 7691 Poplar Ave, Germantown, TN 38138-3904 | 2013-02-13 |
| Find all providers in GERMANTOWN | ||||
| City | GERMANTOWN |
| Zip Code | 38138 |
Please comment or provide details below to improve the information on LESA BEAVER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.