Provider Demographics
NPI:1386129757
Name:BEARD, JESSICA NASHAE (FNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:NASHAE
Last Name:BEARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:SICILY ISLAND
Mailing Address - State:LA
Mailing Address - Zip Code:71368-0008
Mailing Address - Country:US
Mailing Address - Phone:318-389-5727
Mailing Address - Fax:318-389-4028
Practice Address - Street 1:100 SERIO BLVD
Practice Address - Street 2:
Practice Address - City:FERRIDAY
Practice Address - State:LA
Practice Address - Zip Code:71334
Practice Address - Country:US
Practice Address - Phone:318-757-6969
Practice Address - Fax:318-757-6966
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-01
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA204126363LP2300X
TXAP139014363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care