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General NPI Number Information
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NPI Number | 1457452963
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Entity Type | Individual
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Provider Name | JUDITH BEACH NP
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3380 C ST SUITE 100
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City | ANCHORAGE
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State | AK
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Zip | 99503-3920
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Country | US
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Telephone | 907-497-2311
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Fax | 907-497-2310
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Provider Business Mailing Address
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Address Line | 610 BURGUNDY DR
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City | MADISON
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State | TN
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Zip | 37115-3502
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Country | US
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Telephone | 615-860-1365
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 213
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License Number State | AK
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