Provider Demographics
NPI:1841437332
Name:BEAM, SARAH E (CRNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:BEAM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:E
Other - Last Name:THEESFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9009 CORPORATE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-2367
Mailing Address - Country:US
Mailing Address - Phone:321-370-8474
Mailing Address - Fax:855-251-5448
Practice Address - Street 1:9009 CORPORATE LAKE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-2367
Practice Address - Country:US
Practice Address - Phone:321-370-8474
Practice Address - Fax:855-251-5448
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010151363LF0000X
FLARNP9420488363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA148681D99Medicare PIN