Individual
ANNA BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
150 TAYLOR STATION RD STE 250, COLUMBUS, OH 43213-4440
(614) 863-3222
(614) 863-4440
Mailing address
PO BOX 947977, ATLANTA, GA 30394-7977
(561) 948-0291
(561) 859-0429
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.009870RX
OH
363AM0700X
Medical Physician Assistant
Primary
030133
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
745452373
—
NY
Enumeration date
01/12/2022
Last updated
04/20/2026
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