Individual
BRIAN ANDREW BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
4750 YELLOWSTONE AVE, CHUBBUCK, ID 83202-2336
(208) 233-1720
(208) 233-2161
Mailing address
4750 YELLOWSTONE AVE STE A, CHUBBUCK, ID 83202-2336
(208) 233-1720
(203) 233-2161
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
57692
ID
363LF0000X
Family Nurse Practitioner
NUR-APRN-LIC-213661
MT
Other
Enumeration date
03/27/2023
Last updated
08/08/2024
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