Provider Demographics
NPI:1376042655
Name:BEAMAN, RAECHEL (NP)
Entity type:Individual
Prefix:
First Name:RAECHEL
Middle Name:
Last Name:BEAMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 W 16TH ST STE 5100
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2274
Mailing Address - Country:US
Mailing Address - Phone:317-396-1300
Mailing Address - Fax:317-396-1267
Practice Address - Street 1:355 W 16TH ST STE 5100
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2274
Practice Address - Country:US
Practice Address - Phone:317-396-1300
Practice Address - Fax:317-396-1267
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9312731363L00000X
IN71008208A363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300019850Medicaid