Provider Demographics
NPI:1417236662
Name:BEACHY, DEBRA DEHASS (FNP-BC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:DEHASS
Last Name:BEACHY
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:DEHASS LEHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, CNM, FNP-BC
Mailing Address - Street 1:425 W COLONIAL DR STE 303
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6863
Mailing Address - Country:US
Mailing Address - Phone:321-332-6947
Mailing Address - Fax:
Practice Address - Street 1:550 POPE AVE NW STE 200
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4679
Practice Address - Country:US
Practice Address - Phone:863-299-2630
Practice Address - Fax:863-969-0711
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013831363LF0000X
OH2012003569363LF0000X
OHCOA.12493-NM367A00000X
OHCOA12493-NM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0051837Medicaid
OHH079250Medicare PIN