Healthcare Provider Details

I. General information

NPI: 1003145491
Provider Name (Legal Business Name): JESSICA LEIGH BEACH MSN, APRN-CNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2009
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1859 HICKORY HILL DR
COLUMBUS OH
43228-9715
US

IV. Provider business mailing address

1859 HICKORY HILL DR
COLUMBUS OH
43228-9715
US

V. Phone/Fax

Practice location:
  • Phone: 614-592-6952
  • Fax:
Mailing address:
  • Phone: 614-946-3337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN.CNP.0043288
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: