Provider Demographics
NPI:1316827504
Name:BEELINE HEALTH, PLLC
Entity type:Organization
Organization Name:BEELINE HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:BERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:903-721-0112
Mailing Address - Street 1:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:MAYDELLE
Mailing Address - State:TX
Mailing Address - Zip Code:75772-0014
Mailing Address - Country:US
Mailing Address - Phone:903-721-0112
Mailing Address - Fax:
Practice Address - Street 1:305 W RUSK ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-2337
Practice Address - Country:US
Practice Address - Phone:903-721-0112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-06
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty