Provider Demographics
NPI:1679244156
Name:BEECH, LEAH (FNP-C)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:BEECH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 W GARNET ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-5111
Mailing Address - Country:US
Mailing Address - Phone:208-899-7861
Mailing Address - Fax:
Practice Address - Street 1:1150 N SISTER CATHERINE WAY
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-3133
Practice Address - Country:US
Practice Address - Phone:208-302-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID69809207Q00000X
IDF09210398207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine