Healthcare Provider Details

I. General information

NPI: 1760152763
Provider Name (Legal Business Name): ALICE GERMAINE BEUKAM CRNP-PMH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3261 OLD WASHINGTON RD STE 2020
WALDORF MD
20602-3231
US

IV. Provider business mailing address

2407 BENNING RD NE
WASHINGTON DC
20002-4800
US

V. Phone/Fax

Practice location:
  • Phone: 301-263-3786
  • Fax: 301-263-3804
Mailing address:
  • Phone: 202-595-9003
  • Fax: 202-595-9009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR212229
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR212229
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: