Healthcare Provider Details

I. General information

NPI: 1629917612
Provider Name (Legal Business Name): BARBARA JOANN BEATTY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2360 S LINDEN RD
FLINT MI
48532-5483
US

IV. Provider business mailing address

2360 S LINDEN RD
FLINT MI
48532-5483
US

V. Phone/Fax

Practice location:
  • Phone: 810-720-2913
  • Fax: 734-222-4799
Mailing address:
  • Phone: 810-720-2913
  • Fax: 734-222-4799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number4704202545
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: