Healthcare Provider Details

I. General information

NPI: 1811593106
Provider Name (Legal Business Name): SHAINA LYNN BEER AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2020
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2175 ROSALINE AVE
REDDING CA
96001-2549
US

IV. Provider business mailing address

PO BOX 991844
REDDING CA
96099-1844
US

V. Phone/Fax

Practice location:
  • Phone: 530-225-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95016132
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95233803
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28190895A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: