Provider Demographics
NPI:1841633922
Name:BEACH, KATHLEEN M (RN)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:M
Last Name:BEACH
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 1:8159 S BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-2026
Mailing Address - Country:US
Mailing Address - Phone:330-748-4071
Mailing Address - Fax:330-748-4071
Practice Address - Street 1:8159 S BEDFORD RD
Practice Address - Street 2:
Practice Address - City:MACEDONIA
Practice Address - State:OH
Practice Address - Zip Code:44056-2026
Practice Address - Country:US
Practice Address - Phone:330-748-4071
Practice Address - Fax:330-748-4071
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator