MEDICARE: JANE F. BEATO RN, CS, FNP

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	363LF0000X	Family Nurse Practitioner	053268	MO
2	363LF0000X	Family Nurse Practitioner	209-006338	IL

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	:	1972502870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE F. BEATO RN, CS, FNP

Provider Business Mailing Address
First Line	:	670 MASON RIDGE CENTER DR
Second Line	:	STE 300
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-8573
Country	:	US
Telephone Number	:	314-953-6300
Fax Number	:	314-953-6309

Provider Business Practice Location Address
First Line	:	1225 GRAHAM RD
Second Line	:	STE 2310C
City	:	FLORISSANT
State	:	MO
Zip	:	63031-8012
Country	:	US
Telephone Number	:	314-953-6300
Fax Number	:	314-953-6309

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	07/31/2012

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