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1871739995 NPI number — MICHELLE KRISTIE BEAHM NP

NPI Number: 1871739995
Health Care Provider/Practitioner: MICHELLE KRISTIE BEAHM NP

Information about “1871739995” NPI (MICHELLE KRISTIE BEAHM NP) exists in 1871739995 in HTML format HTML  |  1871739995 in plain Text format TXT  |  1871739995 in PDF (Portable Document Format) PDF  |  1871739995 in an XML format XML  formats.

NPI Number : 1871739995 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1871739995",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BEAHM",
    "FirstName": "MICHELLE",
    "MiddleName": "KRISTIE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KONKEL",
    "OtherFirstName": "MICHELLE",
    "OtherMiddleName": "KRISTIE",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "RN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "5555 N PORT WASHINGTON RD STE 200",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GLENDALE",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "53217-4927",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "262-999-3495",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5555 N PORT WASHINGTON RD STE 200",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GLENDALE",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "53217-4927",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "262-999-3495",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/18/2008",
    "LastUpdateDate": "03/04/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "161780-030",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "15751",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": "15751-33",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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