Provider Demographics
NPI:1235578774
Name:BEATTIE, SARAH (CNP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:BEATTIE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 BANEY RD S
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-4502
Mailing Address - Country:US
Mailing Address - Phone:419-289-0333
Mailing Address - Fax:
Practice Address - Street 1:270 PORTLAND WAY S
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-2362
Practice Address - Country:US
Practice Address - Phone:419-462-4656
Practice Address - Fax:419-462-4657
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.307528-COA1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0087929Medicaid
OHH233752OtherMEDICARE