Provider Demographics
NPI:1467996728
Name:BEEMAN, SYLVIA (NP)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:BEEMAN
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 1:110 S HALAGUENO ST STE 4
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-5748
Mailing Address - Country:US
Mailing Address - Phone:575-885-0063
Mailing Address - Fax:575-885-0065
Practice Address - Street 1:110 S HALAGUENO ST STE 4
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-5748
Practice Address - Country:US
Practice Address - Phone:575-885-0063
Practice Address - Fax:575-885-0065
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMGP-01596363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner