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Individual

MARTHA D BEECHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
195 E TOLLISON ST, BAXLEY, GA 31513-0120
(912) 367-0434
(912) 367-0436
Mailing address
PO BOX 2070, BAXLEY, GA 31515-2070
(912) 367-9841
(912) 367-0436

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN124430
GA
363L00000X
Nurse Practitioner
Primary
RN124430
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000807419B
GA
05
000807419C
GA
05
000807419D
GA
Enumeration date
07/03/2006
Last updated
02/09/2010
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