Healthcare Provider Details

I. General information

NPI: 1750633699
Provider Name (Legal Business Name): MARY MARGARET BEEBE MSN, APRN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2012
Last Update Date: 04/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 SIJAN AVE
WHITEMAN AIR FORCE BASE MO
65305-1269
US

IV. Provider business mailing address

331 SIJEN AVE
WHITEMAN AIR FORCE BASE MO
65305-1269
US

V. Phone/Fax

Practice location:
  • Phone: 660-687-4299
  • Fax:
Mailing address:
  • Phone: 660-687-4299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2014034809
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: