Provider Demographics
NPI:1932827169
Name:BEACHUM, WILLIAM BERNARD III (DNP, APRN, FNP-BC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BERNARD
Last Name:BEACHUM
Suffix:III
Gender:M
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
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Mailing Address - Street 1:105 FAR WEST DR STE 201
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3514
Mailing Address - Country:US
Mailing Address - Phone:816-271-8182
Mailing Address - Fax:816-271-8183
Practice Address - Street 1:105 FAR WEST DR STE 201
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3514
Practice Address - Country:US
Practice Address - Phone:816-271-8182
Practice Address - Fax:816-271-8183
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS53-81467-041363LF0000X
MO2022033236363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty