Healthcare Provider Details

I. General information

NPI: 1336139369
Provider Name (Legal Business Name): MELISSA ANN BEAMAN N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 05/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8175 SHERIDAN BLVD UNIT N
ARVADA CO
80003-1928
US

IV. Provider business mailing address

8175 SHERIDAN BLVD UNIT N
ARVADA CO
80003-1928
US

V. Phone/Fax

Practice location:
  • Phone: 303-557-0855
  • Fax: 720-336-3149
Mailing address:
  • Phone: 818-837-5691
  • Fax: 818-792-4793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number13600
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number13600
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0993418
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: