Provider Demographics
NPI:1891935805
Name:BEAM, SUZANNE (RN)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:BEAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 W SILVERDALE RD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85242-6482
Mailing Address - Country:US
Mailing Address - Phone:480-474-6806
Mailing Address - Fax:
Practice Address - Street 1:1255 W SILVERDALE RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85242-6482
Practice Address - Country:US
Practice Address - Phone:480-474-6806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN080376163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse