Provider Demographics
NPI:1316162563
Name:BEATY, NANCY (P,T,)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:BEATY
Suffix:
Gender:F
Credentials:P,T,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 E 1150 S
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:IN
Mailing Address - Zip Code:47234-9554
Mailing Address - Country:US
Mailing Address - Phone:812-390-9760
Mailing Address - Fax:765-525-5410
Practice Address - Street 1:2817 E 1150 S
Practice Address - Street 2:
Practice Address - City:FLAT ROCK
Practice Address - State:IN
Practice Address - Zip Code:47234-9554
Practice Address - Country:US
Practice Address - Phone:812-390-9760
Practice Address - Fax:765-525-5410
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05005000A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist