Provider Demographics
NPI:1134626385
Name:BEACH, JULIE-ANN (AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JULIE-ANN
Middle Name:
Last Name:BEACH
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:JULIE-ANN
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3600 ROUTE 66
Mailing Address - Street 2:FL 3
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-2645
Mailing Address - Country:US
Mailing Address - Phone:732-807-0879
Mailing Address - Fax:201-751-1680
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1915
Practice Address - Country:US
Practice Address - Phone:551-996-2000
Practice Address - Fax:291-751-1680
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN200099363LA2100X
NJ26NJ01057800363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care