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NPI Code Detail

MEDICARE: EDWARD BEAMON

MEDICARE: EDWARD BEAMON
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
1164W00000XLicensed Practical Nurse4703105752MI

General Provider Information

NPI Number : 1922890516
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD BEAMON
Provider Business Mailing Address
First Line : 3924 GALLAGHER ST
Second Line :
City : SAGINAW
State : MI
Zip : 48601-4224
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3924 GALLAGHER ST
Second Line :
City : SAGINAW
State : MI
Zip : 48601-4224
Country : US
Telephone Number : 989-332-2770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2025
Last Update Date : 05/20/2025

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Directions to “ EDWARD BEAMON ” Practice Location

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