Individual
CHARLES JORDAN BEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1 SAINT JOSEPH DR, LEXINGTON, KY 40504-3742
(859) 313-1000
Mailing address
3449 WINDYKNOLL DR, LEXINGTON, KY 40515-5851
(270) 564-5877
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
3017848
KY
Other
Enumeration date
06/10/2022
Last updated
11/07/2022
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