Most Relevant Information
Provider Data
| NPI Number: | 1003325952 |
| Provider Name: | KELSEY BEASLEY |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 209016345 |
Most Important Dates
| Enumeration Date: | 09/22/2017 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
3060 HARVEST MEADOW DR
BELLEVILLE
IL
622217044
Practice Location Phone/Fax
| Phone: | 6187928887 |
| Fax: |
Provider Mailing Location
3060 HARVEST MEADOW DR
BELLEVILLE
IL
622217044
Provider Mailing Phone/Fax
| Phone: | 6187928887 |
| Fax: |