Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 0 | IN |
NPI | 1003209602 |
---|---|
Provider Name | Courtney Beam |
First Address | Indianapolis, IN 46250-1670 |
Second Address | Indianapolis, IN 46250-1670 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2015 |
Last Update Date | 28/01/2021 |