Provider Demographics
NPI:1861546939
Name:BEAZLEY, DARLENE SKINNER (RN)
Entity type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:SKINNER
Last Name:BEAZLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30830-1618
Mailing Address - Country:US
Mailing Address - Phone:706-793-4925
Mailing Address - Fax:
Practice Address - Street 1:114 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:GA
Practice Address - Zip Code:30830-5446
Practice Address - Country:US
Practice Address - Phone:706-554-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN101347163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse