Provider Demographics
NPI:1336139369
Name:BEAMAN, MELISSA ANN (NP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:BEAMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8175 SHERIDAN BLVD
Mailing Address - Street 2:UNIT N
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-1928
Mailing Address - Country:US
Mailing Address - Phone:818-837-5691
Mailing Address - Fax:818-792-4793
Practice Address - Street 1:8175 SHERIDAN BLVD UNIT N
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-1928
Practice Address - Country:US
Practice Address - Phone:303-557-0855
Practice Address - Fax:720-336-3149
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13600363L00000X, 363LP2300X
COAPN.0993418363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAV637ZMedicare PIN