Provider Demographics
NPI:1881979573
Name:BEYER, JANE MARIE (RPH)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:MARIE
Last Name:BEYER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3045 NICCOLET PL
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-2729
Mailing Address - Country:US
Mailing Address - Phone:989-686-5699
Mailing Address - Fax:
Practice Address - Street 1:901 W MIDLAND ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-4288
Practice Address - Country:US
Practice Address - Phone:989-684-9370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist