Anita L Beach, NP

Individual provider Active NPI Family Medicine Physician · Whitefish, MT

NPI 1922064401 · NPPES record last updated Nov 30, 2009

Key facts

NPI
1922064401
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
RN024700 (MT)
Practice address
1111 Baker Ave
Glacier Medical Associates
Whitefish, MT 59937-2901
Phone
(406) 862-2515
Fax
(406) 862-4229
NPI assigned
Apr 25, 2006
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)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN024700MTMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RN024700 MT Yes

Addresses

Primary practice location

1111 Baker Ave
Glacier Medical Associates
Whitefish, MT 59937-2901

Mailing address

1111 Baker Ave
Glacier Medical Associates
Whitefish, MT 59937-2901
Phone (406) 862-2515

Other identifiers

IdentifierTypeStateIssuer
RN024700OtherMTMONTANA STATE LICENSE
500004073OtherMTRAILROAD MEDICARE PIN#
27D0411341OtherMTCLIA ID#---LAB CERT
0432157MedicaidMT
1104882232OtherMTGLACIER MEDICAL ASSOC NPI
CI2709OtherNVRAILROAD MEDICARE GRP ID#
000037436OtherMTBLUE CORSS/SHIELD PIN
810350909OtherMTFEIN
000008287OtherMTMEDICARE PART B GRP ID#

Other providers in Whitefish, MT

All providers in Whitefish, MT · Family Medicine Physician in Montana

Sources for this page

Verify at the official NPI Registry.