MEDICARE: MARJORIE LEE BEIGLE AGNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	4704328425	MI
2	363LA2200X	Adult Health Nurse Practitioner	4704328425	MI

General Provider Information

NPI Number	:	1164206637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARJORIE LEE BEIGLE AGNP

Provider Business Mailing Address
First Line	:	8881 M 119
Second Line	:
City	:	HARBOR SPRINGS
State	:	MI
Zip	:	49740-9816
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8881 M 119
Second Line	:
City	:	HARBOR SPRINGS
State	:	MI
Zip	:	49740-9816
Country	:	US
Telephone Number	:	231-487-2270
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2023
Last Update Date	:	09/08/2023

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