Beavers, Laurie Jean

Beavers, Laurie Jean is an individual health care provider with primary practice located at 8590 Saint Lukes Dr , Beardstown IL 62618-8398. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Beavers, Laurie Jean can be contacted via phone (217) 323-2242.

Contact Information

Primary practice address
8590 Saint Lukes Dr Beardstown IL 62618-8398
Phone: (217) 323-2242
Fax: (217) 452-7245
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209 000817 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 209 000817 Illinois

Profile Details

NPI number 1386747343
LBN Legal business name Beavers, Laurie Jean
Credentials FAMILY NURSE PRACTIT
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2006
Last updated Sep 21st, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386747343 NPPES
Illinois MEDICAID 370661499007

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