Provider Demographics
NPI:1174680292
Name:BEITING, MARY L (CNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:L
Last Name:BEITING
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 636256
Mailing Address - Street 2:CENTRAL CREDENTIALING
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6256
Mailing Address - Country:US
Mailing Address - Phone:513-585-5504
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:231 ALBERT SABIN WAY
Practice Address - Street 2:ML 0585
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267-0585
Practice Address - Country:US
Practice Address - Phone:513-558-5468
Practice Address - Fax:513-558-4309
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2017-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH159305163W00000X, 363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200864500Medicaid
KY7100039820Medicaid
OH2734349Medicaid
OH2734349Medicaid