Provider Demographics
NPI:1457858912
Name:BEEBE, CYNTHIA D
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:D
Last Name:BEEBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MAIN CARTER ROAD
Mailing Address - Street 2:
Mailing Address - City:QUINHAGAK
Mailing Address - State:AK
Mailing Address - Zip Code:99655
Mailing Address - Country:US
Mailing Address - Phone:907-556-8320
Mailing Address - Fax:907-556-8340
Practice Address - Street 1:101 MAIN CARTER ROAD
Practice Address - Street 2:
Practice Address - City:QUINHAGAK
Practice Address - State:AK
Practice Address - Zip Code:99655
Practice Address - Country:US
Practice Address - Phone:907-556-8320
Practice Address - Fax:907-556-8340
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker