Individual
LAURIE ANN BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
212 COLLEGE ST, PILOT GROVE, MO 65276-1005
(660) 831-3728
(660) 831-3326
Mailing address
PO BOX 271430, FORT COLLINS, CO 80527-1430
(970) 488-1640
(970) 472-9381
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
110297
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000082595
MEDICARE NUMBER
MO
01
—
001014600
MEDICARE PART B
MO
Enumeration date
06/21/2005
Last updated
02/25/2022
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