Provider Demographics
NPI:1215072954
Name:BEARD, JANET JEANINE (MSPT)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:JEANINE
Last Name:BEARD
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MS
Other - First Name:JANET
Other - Middle Name:JEANINE
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1213 N BELT HWY
Mailing Address - Street 2:STE H
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2485
Mailing Address - Country:US
Mailing Address - Phone:816-279-7778
Mailing Address - Fax:816-279-8788
Practice Address - Street 1:1213 N BELT HWY STE H
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2485
Practice Address - Country:US
Practice Address - Phone:816-279-7778
Practice Address - Fax:866-245-8064
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO100007225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO20619019OtherBCBS
MO20619019OtherBCBS
X90000004Medicare PIN