Provider Demographics
NPI:1437397163
Name:BEACH, KATHARINE ELIZABETH (MSN, RN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:KATHARINE
Middle Name:ELIZABETH
Last Name:BEACH
Suffix:
Gender:F
Credentials:MSN, RN, FNP
Other - Prefix:MS
Other - First Name:KATHARINE
Other - Middle Name:ELIZABETH
Other - Last Name:BELCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN, FNP
Mailing Address - Street 1:23934 W MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:GENOA
Mailing Address - State:OH
Mailing Address - Zip Code:43430-1032
Mailing Address - Country:US
Mailing Address - Phone:419-306-5330
Mailing Address - Fax:
Practice Address - Street 1:3740 W SYLVANIA AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4461
Practice Address - Country:US
Practice Address - Phone:419-473-6670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-03
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.328171163W00000X
OHCOA.13710-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCOA.13710-NPOtherSTATE OF OHIO BOARD OF NURSING
OHRX-13710-EX1OtherPRESCRIPTIVE AUTHORITY - EXTERNSHIP