Provider Demographics
NPI:1518221670
Name:BEATY, CHANDA DACAYANA (NP)
Entity Type:Individual
Prefix:
First Name:CHANDA
Middle Name:DACAYANA
Last Name:BEATY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 ROUTE 6A
Mailing Address - Street 2:BUILDING 7 APEX HEALTH
Mailing Address - City:YARMOUTHPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02675
Mailing Address - Country:US
Mailing Address - Phone:508-362-5999
Mailing Address - Fax:508-362-5901
Practice Address - Street 1:923 ROUTE 6A
Practice Address - Street 2:BUILDING 7 APEX HEALTH
Practice Address - City:YARMOUTHPORT
Practice Address - State:MA
Practice Address - Zip Code:02675
Practice Address - Country:US
Practice Address - Phone:508-362-5999
Practice Address - Fax:508-362-5901
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN266523363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health