Provider Demographics
NPI:1891070504
Name:BEATTY, RONDA KAY (RN)
Entity Type:Individual
Prefix:MRS
First Name:RONDA
Middle Name:KAY
Last Name:BEATTY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RONDA
Other - Middle Name:
Other - Last Name:BEATTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 572
Mailing Address - Street 2:
Mailing Address - City:NEW STRAITSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43766-0572
Mailing Address - Country:US
Mailing Address - Phone:740-605-4316
Mailing Address - Fax:
Practice Address - Street 1:305 DAVIS ST
Practice Address - Street 2:
Practice Address - City:NEW STRAITSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43766-9540
Practice Address - Country:US
Practice Address - Phone:740-605-4316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN375323163WH0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health