Provider Demographics
NPI:1649599259
Name:BEATY, DIANE EW (RN)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:EW
Last Name:BEATY
Suffix:
Gender:F
Credentials:RN
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 129
Mailing Address - Street 2:
Mailing Address - City:OVERPECK
Mailing Address - State:OH
Mailing Address - Zip Code:45055-0129
Mailing Address - Country:US
Mailing Address - Phone:513-266-5041
Mailing Address - Fax:
Practice Address - Street 1:4238 MORGANTHALER RD.
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011
Practice Address - Country:US
Practice Address - Phone:513-266-5041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN353163163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health