Individual
HOLLY BEACHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4437 MAIN ST, SHALLOTTE, NC 28470-4451
(910) 754-4449
Mailing address
4437 MAIN ST, SHALLOTTE, NC 28470-4451
(910) 754-4449
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
214331
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214331
—
NC
Enumeration date
02/12/2020
Last updated
02/12/2020
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