Individual
KATHERINE GLEASON BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
100 BRICKHILL AVE, SOUTH PORTLAND, ME 04106-1999
(207) 761-1502
(207) 774-2015
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
CNM82029
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040608
ANTHEM
ME
05
—
274220099
—
ME
05
—
30347515
—
NH
01
—
420000116
GBA PALMETTO/RR MEDICARE
ME
Enumeration date
10/27/2005
Last updated
02/17/2012
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