Provider Demographics
NPI:1578131629
Name:BEACHY, FELICIA ANN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:ANN
Last Name:BEACHY
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1677 SHATTO AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-6351
Mailing Address - Country:US
Mailing Address - Phone:330-312-1307
Mailing Address - Fax:
Practice Address - Street 1:100 LILLIAN GISH BLVD SW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647-6587
Practice Address - Country:US
Practice Address - Phone:330-809-0460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029042363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health