Provider Demographics
NPI:1922289826
Name:BEATY, KAREN L (RN PHN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:BEATY
Suffix:
Gender:F
Credentials:RN PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:BLDG 83
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92702-0355
Mailing Address - Country:US
Mailing Address - Phone:714-896-7809
Mailing Address - Fax:
Practice Address - Street 1:14180 BEACH BLVD
Practice Address - Street 2:206
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4452
Practice Address - Country:US
Practice Address - Phone:714-896-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA335586163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health