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NPI Code Detail

MEDICARE: MRS. MICHELLE KRISTIE BEAHM NP

MEDICARE: MRS. MICHELLE KRISTIE BEAHM NP
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
1163W00000XRegistered Nurse161780-030WI
2363L00000XNurse Practitioner15751WI
3363LP0808XPsychiatric/Mental Health Nurse Practitioner15751-33WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871739995
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE KRISTIE BEAHM NP
Provider Business Mailing Address
First Line : 5555 N PORT WASHINGTON RD STE 200
Second Line :
City : GLENDALE
State : WI
Zip : 53217-4927
Country : US
Telephone Number : 262-999-3495
Fax Number :
Provider Business Practice Location Address
First Line : 5555 N PORT WASHINGTON RD STE 200
Second Line :
City : GLENDALE
State : WI
Zip : 53217-4927
Country : US
Telephone Number : 262-999-3495
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2008
Last Update Date : 03/04/2025

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