Healthcare Provider Details

I. General information

NPI: 1770023863
Provider Name (Legal Business Name): LINDA M BEATSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA M DREW

II. Dates (important events)

Enumeration Date: 03/08/2017
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 RILEY HOSPITAL DR ROOM 1134
INDIANAPOLIS IN
46202-5109
US

IV. Provider business mailing address

13713 ASHWOOD LN
FISHERS IN
46038-8514
US

V. Phone/Fax

Practice location:
  • Phone: 317-396-1300
  • Fax: 317-396-1346
Mailing address:
  • Phone: 617-347-3011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28228928A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: