Healthcare Provider Details

I. General information

NPI: 1053250258
Provider Name (Legal Business Name): ALISON MAE BEATTY APRN, CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 W CENTRAL AVE STE 100A
TOLEDO OH
43606-3817
US

IV. Provider business mailing address

2100 W CENTRAL AVE STE 100A
TOLEDO OH
43606-3817
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-8410
  • Fax: 419-291-8405
Mailing address:
  • Phone: 419-291-8410
  • Fax: 419-291-8405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN.CNP.0031638
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: