Provider Demographics
NPI:1710981709
Name:BEEBE, JANET M (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:M
Last Name:BEEBE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14999 HEALTH CENTER DR
Mailing Address - Street 2:STE 201
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1087
Mailing Address - Country:US
Mailing Address - Phone:301-262-8188
Mailing Address - Fax:301-464-8233
Practice Address - Street 1:14999 HEALTH CENTER DR
Practice Address - Street 2:STE 201
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1087
Practice Address - Country:US
Practice Address - Phone:301-262-8188
Practice Address - Fax:301-464-8233
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR112087363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDQ09755Medicare UPIN
MD177995Medicare ID - Type Unspecified