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Individual

MRS. AMY REBECCA BEACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1684 FOOTE AVENUE EXT, JAMESTOWN, NY 14701-9385
(716) 661-9730
(716) 661-9732
Mailing address
1684 FOOTE AVENUE EXT, JAMESTOWN, NY 14701-9385
(716) 661-9730
(716) 661-9732

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F3308961
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00026507402
UNIVERA
01
000560438003
COMM BLUE
05
01568501
NY
01
161570481
TAX ID
01
9511745
INDEP HEALTH
01
CA8673
RAILROAD MEDICARE
01
F3308961
LIC
NY
01
P00131876
RAILROAD MEDICARE
Enumeration date
03/03/2006
Last updated
03/07/2023
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