Provider Demographics
NPI:1740958495
Name:BEECHUM, REBECCA (RN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BEECHUM
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 1:2081 KENNETH DR
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-9735
Mailing Address - Country:US
Mailing Address - Phone:989-615-0826
Mailing Address - Fax:
Practice Address - Street 1:2081 KENNETH DR
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-9735
Practice Address - Country:US
Practice Address - Phone:989-615-0826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704276158163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse