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General NPI Number Information
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NPI Number | 1003815697
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Entity Type | Individual
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Provider Name | STEVEN L. BEATY CRNA
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Gender | Male
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 1994 GALLATIN PIKE N SUITE 202
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City | MADISON
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State | TN
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Zip | 37115-2026
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Country | US
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Telephone | 615-851-0001
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Fax | 615-851-0021
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Provider Business Mailing Address
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Address Line | PO BOX 2344
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City | INDIANAPOLIS
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State | IN
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Zip | 46206-2344
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Country | US
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Telephone | 866-857-4190
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Fax | 800-731-0751
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 11406
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License Number State | TN
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