Healthcare Provider Details

I. General information

NPI: 1306513635
Provider Name (Legal Business Name): LAURIE ANN BEAM APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 TOWSON AVE
FORT SMITH AR
72901-4921
US

IV. Provider business mailing address

9505 CHAD COLLEY BLVD # 4103
FORT SMITH AR
72916-5800
US

V. Phone/Fax

Practice location:
  • Phone: 479-441-4000
  • Fax:
Mailing address:
  • Phone: 405-278-1972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number217351
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number217351
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: