Individual
STACIE MICHELLE BEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
601 E MAIN ST, WAYNESBORO, PA 17268-2332
(717) 765-5088
(717) 765-5066
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
(717) 851-6969
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
R139236
MD
363LA2200X
Adult Health Nurse Practitioner
Primary
SP022183
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103802293
—
PA
01
—
12667440
CAQH
—
01
—
1619241007
NPI
—
Enumeration date
03/02/2012
Last updated
08/22/2025
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