Provider Demographics
NPI:1841626207
Name:BEEMAN, GINA MARY (LPN)
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:MARY
Last Name:BEEMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10919 W LAURELWOOD LN
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-4033
Mailing Address - Country:US
Mailing Address - Phone:480-291-3805
Mailing Address - Fax:
Practice Address - Street 1:8520 N 47TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-5100
Practice Address - Country:US
Practice Address - Phone:623-237-5010
Practice Address - Fax:623-237-5015
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP044025164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse