Provider Demographics
NPI:1821528886
Name:BEATIE, REGINA (RN, MSN)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:BEATIE
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:
Other - Last Name:BEATIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, MSN
Mailing Address - Street 1:1072 FIDDLER CRAB RD NE
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:GA
Mailing Address - Zip Code:31331-7800
Mailing Address - Country:US
Mailing Address - Phone:912-832-2673
Mailing Address - Fax:912-658-8043
Practice Address - Street 1:1072 FIDDLER CRAB RD NE
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:GA
Practice Address - Zip Code:31331-7800
Practice Address - Country:US
Practice Address - Phone:912-832-2673
Practice Address - Fax:912-658-8043
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN062374364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist