| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ALEXANDRA JANE BEACHNAU | 1114544343 | 2020-07-04 |
Alexandra Jane Beachnau is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1114544343. Registration indicates Alexandra Jane Beachnau is a provider of access to ophthalmic care services with a specialization in Eye & Vision Services Providers, Optometrist (Eye and Vision Services Providers, Optometrist) (Optometrist, ) (Vision/Audiology, ) (Optometrist, Eye and Vision Services Providers)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Dr. Alexandra Jane Beachnau OD |
| Practice Office Address | 925 N 87TH ST MILWAUKEE, WI US |
| Practice Office Telephone | 4146075280 |
| Practice Office Fax | 4149556300 |
| Mailing Address | 925 N 87TH ST MILWAUKEE, WI 532264812 US |
| Business Telephone | 4146075280 |
| Business Fax | 4149556300 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 8701 W Watertown Plank Rd | Milwaukee, WI 532263548 | 4149558245 |
| 925 N 87th St | Milwaukee, WI 532264812 | 4149552020 / 4149556166 |
| 9000 W Wisconsin Ave | Milwaukee, WI 532264874 | 4149552020 / 4149556166 |
| 4805 S Moorland Rd | New Berlin, WI 531517401 | 2627987200 / 4142662027 |
| Code | Practice | License No State |
|---|---|---|
| 152W00000X PRIMARY | Access to Ophthalmic Care Eye & Vision Services Providers Optometrist Eye and Vision Services Providers Optometrist Optometrist Vision/Audiology Optometrist Eye and Vision Services Providers | 3627-35
WI |
| 1114544343 | MEDICAID | WI |