Individual
LOUIE WARD BEECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1510 12TH AVE, STE 200, NAMPA, ID 83686
(208) 302-6800
(208) 302-6855
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642
(208) 302-6800
(208) 302-6855
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1103
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114515
NCCPA
ID
Enumeration date
10/03/2013
Last updated
09/05/2018
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