Provider Demographics
NPI:1801007299
Name:BEECHAM, NANCY LEE (R N C)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LEE
Last Name:BEECHAM
Suffix:
Gender:F
Credentials:R N C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1827 DIESEL DR
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-1153
Mailing Address - Country:US
Mailing Address - Phone:619-590-0723
Mailing Address - Fax:619-590-0777
Practice Address - Street 1:1827 DIESEL DR
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-1153
Practice Address - Country:US
Practice Address - Phone:619-590-0723
Practice Address - Fax:619-590-0777
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC394708163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC394708OtherREGISTERED NURSE NUMBER