Provider Demographics
NPI:1902115652
Name:BEATTIE, SARAH L (ARNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:BEATTIE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 NE 14TH ST STE 36
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-8903
Mailing Address - Country:US
Mailing Address - Phone:515-289-1515
Mailing Address - Fax:515-289-1511
Practice Address - Street 1:6950 NE 14TH ST STE 36
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-8903
Practice Address - Country:US
Practice Address - Phone:515-289-1515
Practice Address - Fax:515-289-1511
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00000364SP0808X
IAG108504363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1902115652OtherBCBS
321119OtherVALUE OPTIONS
IA0058230Medicaid