Lisa Joan Beaver, RN

Individual provider Active NPI Ambulatory Care Registered Nurse · Leavenworth, KS

NPI 1104693480 · NPPES record last updated Dec 7, 2023

Key facts

NPI
1104693480
Entity type
Individual (NPI type 1)
Primary specialty
Ambulatory Care Registered Nurse 163WP2201X
License
13-87161 (KS)
Practice address
Leavenworth Vamc
4101 South Trafficway
Leavenworth, KS 66048
Phone
(913) 682-2000
Fax
(913) 758-4119
NPI assigned
Dec 7, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
13-87161KSMDAmbulatory Care Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 13-87161 KS Yes

Addresses

Primary practice location

Leavenworth Vamc
4101 South Trafficway
Leavenworth, KS 66048

Mailing address

4408 Lakeview Dr
Leavenworth, KS 66048-4934
Phone (913) 682-2000

Other providers in Leavenworth, KS

All providers in Leavenworth, KS · Ambulatory Care Registered Nurse in Kansas

Sources for this page

Verify at the official NPI Registry.