Healthcare Provider Details

I. General information

NPI: 1275454498
Provider Name (Legal Business Name): ANGELINA BEAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1633 STATE ROUTE 51 SUITE 105
JEFFERSON HILLS PA
15025
US

IV. Provider business mailing address

1447 STATE ROUTE 130
GREENSBURG PA
15601-9588
US

V. Phone/Fax

Practice location:
  • Phone: 412-775-2019
  • Fax: 412-755-2243
Mailing address:
  • Phone: 724-359-8285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP035701
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: