Provider Demographics
NPI:1649485798
Name:BEESON, LYNN CORBIN (CRNA)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:CORBIN
Last Name:BEESON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 PEACHTREE LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:ADVANCE
Mailing Address - State:NC
Mailing Address - Zip Code:27006-6782
Mailing Address - Country:US
Mailing Address - Phone:336-998-3396
Mailing Address - Fax:336-998-2889
Practice Address - Street 1:3812 N ELM ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2596
Practice Address - Country:US
Practice Address - Phone:336-294-1833
Practice Address - Fax:336-294-8831
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC043151367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC16186OtherPARTNERS
NC2603407BOtherMEDICARE INDIVIDUAL PTAN
NC0264UOtherBCBS