Provider Demographics
NPI:1932236825
Name:BEATY, KATHY MAE (CNA)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:MAE
Last Name:BEATY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 WOODLAWN DR
Mailing Address - Street 2:
Mailing Address - City:BYRDSTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38549-2317
Mailing Address - Country:US
Mailing Address - Phone:931-864-3178
Mailing Address - Fax:931-864-3376
Practice Address - Street 1:1013 WOODLAWN DR
Practice Address - Street 2:
Practice Address - City:BYRDSTOWN
Practice Address - State:TN
Practice Address - Zip Code:38549-2317
Practice Address - Country:US
Practice Address - Phone:931-864-3178
Practice Address - Fax:931-864-3376
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide