Provider Demographics
NPI:1538305107
Name:BEAM, RUTH ANNETTE (CNS-BC)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ANNETTE
Last Name:BEAM
Suffix:
Gender:F
Credentials:CNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4355 HICKORY BLVD
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:NC
Mailing Address - Zip Code:28630-1992
Mailing Address - Country:US
Mailing Address - Phone:828-757-5040
Mailing Address - Fax:828-757-5041
Practice Address - Street 1:4355 HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630-1992
Practice Address - Country:US
Practice Address - Phone:828-757-5040
Practice Address - Fax:828-757-5041
Is Sole Proprietor?:No
Enumeration Date:2009-01-01
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC045100163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2102144Medicaid