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General NPI Number Information
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NPI Number | 1043157092
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Entity Type | Individual
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Provider Name | KARA THERESA BEATTIE
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Gender | Female
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Dates
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Enumeration Date | 04/29/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 24008 BELLEAU
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City | STAFFORD
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State | VA
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Zip | 22556
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Country | US
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Telephone | 703-784-5541
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Fax |
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Provider Business Mailing Address
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Address Line | 207 W SEYMOUR ST
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City | APPLETON
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State | WI
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Zip | 54915-1328
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Country | US
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Telephone | 703-479-4211
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 244176-30
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License Number State | WI
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