James Glenn Beasley, CFNP

Individual provider Active NPI Family Nurse Practitioner · Tripler AMC, HI

NPI 1255313987 · NPPES record last updated Jul 21, 2023

Key facts

NPI
1255313987
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
1071 (HI)
Practice address
1 Jarrett White Rd
Tripler AMC, HI 96859-5001
Phone
(808) 433-8622
Fax
(808) 433-8334
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1071HIMDFamily Nurse Practitioner
0024165406VAMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1071 HI Yes
Family Nurse Practitioner 363LF0000X 0024165406 VA

Addresses

Primary practice location

1 Jarrett White Rd
Tripler AMC, HI 96859-5001

Mailing address

92-112 Aweuweu PL a
Kapolei, HI 96707
Phone (808) 433-8622

Other providers in Tripler AMC, HI

All providers in Tripler AMC, HI · Family Nurse Practitioner in Hawaii

Sources for this page

Verify at the official NPI Registry.