Provider Demographics
NPI:1952554057
Name:BEATTIE, JANET MARIE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:MARIE
Last Name:BEATTIE
Suffix:
Gender:F
Credentials:FNP-BC
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 779
Mailing Address - Street 2:
Mailing Address - City:TAWAS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48764-0779
Mailing Address - Country:US
Mailing Address - Phone:989-488-5410
Mailing Address - Fax:989-488-5411
Practice Address - Street 1:4599 TOWNE CENTRE RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2804
Practice Address - Country:US
Practice Address - Phone:989-497-3226
Practice Address - Fax:989-497-3146
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704190454363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner