Provider Demographics
NPI:1972264075
Name:BEAMAN, ALLISON (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BEAMAN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25139 USTICK RD
Mailing Address - Street 2:
Mailing Address - City:WILDER
Mailing Address - State:ID
Mailing Address - Zip Code:83676-5539
Mailing Address - Country:US
Mailing Address - Phone:208-954-1717
Mailing Address - Fax:
Practice Address - Street 1:3904 E FLAMINGO AVE STE 100
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-3144
Practice Address - Country:US
Practice Address - Phone:208-465-7121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-01
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID37183163WH1000X
ID71430363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH1000XNursing Service ProvidersRegistered NurseHospice