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Individual

JANUARY LEE BEACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-CNP

Contact information

Practice address
1902 TAMARACK RD, NEWARK, OH 43055-2303
(220) 564-7975
(220) 564-7976
Mailing address
1902 TAMARACK RD, NEWARK, OH 43055-2303
(220) 564-7975
(220) 564-7976

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.023351
OH
363LA2200X
Adult Health Nurse Practitioner
APRN.CNP.023351
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0307823
OH
Enumeration date
07/31/2018
Last updated
01/23/2024
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