Provider Demographics
NPI:1801317458
Name:BEACHAM, CAITLYN (ARNP)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:BEACHAM
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:
Other - Last Name:BIERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1600 LAKELAND HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-3019
Mailing Address - Country:US
Mailing Address - Phone:863-680-7000
Mailing Address - Fax:866-264-8519
Practice Address - Street 1:1600 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-3019
Practice Address - Country:US
Practice Address - Phone:863-680-7300
Practice Address - Fax:866-264-8519
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9361563363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health