Healthcare Provider Details

I. General information

NPI: 1649854811
Provider Name (Legal Business Name): SARAH K BEAHAM APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2021
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9111 BROADWAY
MERRILLVILLE IN
46410-8122
US

IV. Provider business mailing address

7570 E 121ST PL
CROWN POINT IN
46307-0075
US

V. Phone/Fax

Practice location:
  • Phone: 219-689-1941
  • Fax:
Mailing address:
  • Phone: 219-689-1941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71011105A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71011105A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: