Provider Demographics
NPI:1972683845
Name:BEEHLER, CONNIE J (MD)
Entity type:Individual
Prefix:DR
First Name:CONNIE
Middle Name:J
Last Name:BEEHLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 AVENUE B
Mailing Address - Street 2:REGIONAL WEST MEDICAL CENTER
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4602
Mailing Address - Country:US
Mailing Address - Phone:308-635-3711
Mailing Address - Fax:308-630-2288
Practice Address - Street 1:4021 AVENUE B
Practice Address - Street 2:REGIONAL WEST MEDICAL CENTER
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4602
Practice Address - Country:US
Practice Address - Phone:308-635-3711
Practice Address - Fax:308-630-2288
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE24832207RH0002X
NY239531207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEP00729562Medicare PIN
NE098147018Medicare PIN