Individual
MRS. MICHELLE KRISTIE BEAHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5555 N PORT WASHINGTON RD STE 200, GLENDALE, WI 53217-4927
(262) 999-3495
Mailing address
5555 N PORT WASHINGTON RD STE 200, GLENDALE, WI 53217-4927
(262) 999-3495
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
161780-030
WI
363L00000X
Nurse Practitioner
15751
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
15751-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871739995
—
WI
Enumeration date
12/18/2008
Last updated
03/04/2025
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