# MRS. GRETCHEN MICHELLE BEAGLES

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1154486629
- **Gender:** F
- **Credential:** CCP LP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 242T00000X | Perfusionist | LP63 | OK | Yes |
| 247200000X | Other Technician | LP63 | OK | — |

## Other

- **Enumeration date:** 12/26/2006
- **Last updated:** 03/29/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5993501 | AETNA | — |
| 01 | — | 731522080002 | BCBS | — |