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NPI Profile for LAURIE A BEACH in PILOT GROVE, MO.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1811993264 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 06/21/2005 | |
| Last updated | 02/25/2022 - About 4 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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LAURIE A BEACH
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LAURIE A BEACH