Provider Demographics
NPI:1356344311
Name:BEAMAN, JANICE (NP, CNM)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:BEAMAN
Suffix:
Gender:F
Credentials:NP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 BROAD RD
Mailing Address - Street 2:STE 2C
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215-5103
Mailing Address - Country:US
Mailing Address - Phone:315-492-5915
Mailing Address - Fax:315-492-5210
Practice Address - Street 1:4850 BROAD RD
Practice Address - Street 2:STE 2C
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215-5103
Practice Address - Country:US
Practice Address - Phone:315-492-5915
Practice Address - Fax:315-492-5210
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF000868367A00000X
NYF420685363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health