Provider Demographics
NPI:1861636961
Name:BEAL, ELIZABETH ANN (MD)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:BEAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:ORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8804 RENNER BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219
Mailing Address - Country:US
Mailing Address - Phone:913-676-8400
Mailing Address - Fax:913-599-1692
Practice Address - Street 1:8804 RENNER BLVD
Practice Address - Street 2:STE 200
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219
Practice Address - Country:US
Practice Address - Phone:913-676-8400
Practice Address - Fax:913-599-1692
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-33753207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine