MEDICARE: BARBARA A. BEATTY NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	28177135	IN
2	363LP0200X	Pediatric Nurse Practitioner	71005626A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790161800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA A. BEATTY NP

Provider Business Mailing Address
First Line	:	228 5TH AVE SW
Second Line	:
City	:	ALBANY
State	:	OR
Zip	:	97321-0052
Country	:	US
Telephone Number	:	541-926-2203
Fax Number	:	541-926-1378

Provider Business Practice Location Address
First Line	:	705 RILEY HOSPITAL DR
Second Line	:	RI 3038C
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5109
Country	:	US
Telephone Number	:	317-274-2617
Fax Number	:	317-278-2587

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2015
Last Update Date	:	05/11/2026

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