# ANITA L BEACH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1922064401
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | RN024700 | MT | Yes |

## Other

- **Enumeration date:** 04/25/2006
- **Last updated:** 11/30/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000008287 | MEDICARE PART B GRP ID\# | MT |
| 01 | — | 000037436 | BLUE CORSS/SHIELD PIN | MT |
| 05 | — | 0432157 | — | MT |
| 01 | — | 1104882232 | GLACIER MEDICAL ASSOC NPI | MT |
| 01 | — | 27D0411341 | CLIA ID\#---LAB CERT | MT |
| 01 | — | 500004073 | RAILROAD MEDICARE PIN\# | MT |
| 01 | — | 810350909 | FEIN | MT |
| 01 | — | CI2709 | RAILROAD MEDICARE GRP ID\# | NV |
| 01 | — | RN024700 | MONTANA STATE LICENSE | MT |