Individual
MRS. MARIJANE RABOIN BEELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4123 DUTCHMANS LN STE 503, LOUISVILLE, KY 40207-4730
(502) 409-5600
(502) 409-5606
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
7100790
IN
363LW0102X
Women's Health Nurse Practitioner
Primary
3004812
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000215953
BC/BS FACETS
IN
05
—
200489110
—
IN
01
—
500029280
MEDICARE RAILROAD
IN
05
—
7100272410
—
KY
01
—
K099480
MEDICARE PTAN - WS
KY
01
—
P01300054
RR MEDICARE
KY
Enumeration date
06/15/2005
Last updated
03/28/2017
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