Provider Demographics
NPI:1194900944
Name:BEASLEY, KRISTIN NICOLE (DVM)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:NICOLE
Last Name:BEASLEY
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1093 SANDY PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-6537
Mailing Address - Country:US
Mailing Address - Phone:770-424-6303
Mailing Address - Fax:770-426-4257
Practice Address - Street 1:1093 SANDY PLAINS RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-6537
Practice Address - Country:US
Practice Address - Phone:770-424-6303
Practice Address - Fax:770-426-4257
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAVET007699174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian