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KERA BEACHAM

Physician Assistants & Advanced Practice Nursing Providers Nurse Anesthetist, Certified Registered

Provider NPI: 1851837074

Provider Information:
 KERA  BEACHAM 
Gender: F
Not Sole Proprietor

Practice Location:
600 GRESHAM DR  NORFOLK, VA 23507-1904 US
Tel: 757-473-0055  Fax: 757-473-0075

Business Mailing Address:
134 BUSINESS PARK DR  VIRGINIA BEACH, VA 23462-6523 US
Tel: 757-473-0055  Fax: 757-473-0075

NPI Information:
NPI: 1851837074
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y367500000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Anesthetist, Certified Registered
VA0024174422

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 367500000X

Type:

Classification:



Definition:



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