Healthcare Provider Details

I. General information

NPI: 1205424397
Provider Name (Legal Business Name): NATHAN A BEIER ACNPC-AG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2021
Last Update Date: 08/04/2022
Certification Date: 08/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 OAK PARK BLVD
LAKE CHARLES LA
70601-8911
US

IV. Provider business mailing address

1100 REID PKWY
RICHMOND IN
47374-1157
US

V. Phone/Fax

Practice location:
  • Phone: 374-943-4720
  • Fax:
Mailing address:
  • Phone: 765-983-3000
  • Fax: 765-935-8944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number225017
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number71010809A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAPRN.CNP.0027088
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: