Provider Demographics
NPI:1093429300
Name:BEALS, KAYLEE MARIE (DNP, APRN FNP-BC)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:MARIE
Last Name:BEALS
Suffix:
Gender:F
Credentials:DNP, APRN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-2190
Mailing Address - Country:US
Mailing Address - Phone:217-342-2066
Mailing Address - Fax:
Practice Address - Street 1:905 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-2190
Practice Address - Country:US
Practice Address - Phone:217-342-2066
Practice Address - Fax:217-342-2074
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209028709363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily