Healthcare Provider Details

I. General information

NPI: 1437397163
Provider Name (Legal Business Name): KATHARINE ELIZABETH BEACH MSN, RN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHARINE ELIZABETH BELCHER MSN, RN, FNP

II. Dates (important events)

Enumeration Date: 02/03/2009
Last Update Date: 12/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3740 W SYLVANIA AVE SUITE 250
TOLEDO OH
43623-4461
US

IV. Provider business mailing address

23934 W MEADOW DR
GENOA OH
43430-1032
US

V. Phone/Fax

Practice location:
  • Phone: 419-473-6670
  • Fax:
Mailing address:
  • Phone: 419-306-5330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.328171
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.13710-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: