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NPI Code Detail

MEDICARE: PATRICIA VICKERY BEAM ACNP-BC

MEDICARE: PATRICIA VICKERY BEAM ACNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse Practitioner1-061184AL

General Provider Information

NPI Number : 1699009514
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA VICKERY BEAM ACNP-BC
Provider Business Mailing Address
First Line : 2601 VILLAGE PROFESSIONAL DR N
Second Line :
City : OPELIKA
State : AL
Zip : 36801-4784
Country : US
Telephone Number : 334-528-5400
Fax Number : 334-528-5421
Provider Business Practice Location Address
First Line : 2601 VILLAGE PROFESSIONAL DR N
Second Line :
City : OPELIKA
State : AL
Zip : 36801-4784
Country : US
Telephone Number : 334-528-5400
Fax Number : 334-528-5421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2009
Last Update Date : 08/16/2021

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