Healthcare Provider Details

I. General information

NPI: 1609359561
Provider Name (Legal Business Name): AUDREY E BEERS CPM, CDM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2018
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 JESSUP DR
FORT COLLINS CO
80525-2550
US

IV. Provider business mailing address

2905 NEIL DR APT 21
FORT COLLINS CO
80526-6624
US

V. Phone/Fax

Practice location:
  • Phone: 866-218-5769
  • Fax: 866-218-5769
Mailing address:
  • Phone: 907-521-0482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number136164
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: