Provider Demographics
NPI:1053123232
Name:BEARD, PATSY SUE (PTA, BS)
Entity type:Individual
Prefix:
First Name:PATSY
Middle Name:SUE
Last Name:BEARD
Suffix:
Gender:F
Credentials:PTA, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 MILLERVILLE RD APT 9200
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-0107
Mailing Address - Country:US
Mailing Address - Phone:318-794-9564
Mailing Address - Fax:
Practice Address - Street 1:4604 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-3056
Practice Address - Country:US
Practice Address - Phone:225-922-9923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAA10984225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant