Healthcare Provider Details

I. General information

NPI: 1811425432
Provider Name (Legal Business Name): JULIE LYNN BEITER PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2017
Last Update Date: 05/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 AMERICAN WAY STE A
WEIRTON WV
26062-4083
US

IV. Provider business mailing address

145 N MAIDEN ST
WAYNESBURG PA
15370-1715
US

V. Phone/Fax

Practice location:
  • Phone: 304-797-6410
  • Fax:
Mailing address:
  • Phone: 724-255-5817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN89902-PMHNP-BC
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP017477
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number89902
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN624232
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: