Healthcare Provider Details
I. General information
NPI: 1952554057
Provider Name (Legal Business Name): JANET MARIE BEATTIE FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/03/2008
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1484 STRAITS DR STE 5
BAY CITY MI
48706-8718
US
IV. Provider business mailing address
PO BOX 40412
BELFAST ME
04915-1255
US
V. Phone/Fax
- Phone: 989-667-8740
- Fax:
- Phone: 248-824-6032
- Fax: 855-618-6655
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 4704190454 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 4704190454 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: