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NPI Code Detail

MEDICARE: DR. STEPHANIE NICOLE BEATTY PT, DPT

MEDICARE: DR. STEPHANIE NICOLE BEATTY PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1245808872
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHANIE NICOLE BEATTY PT, DPT
Provider Business Mailing Address
First Line : 7332 MORRISON DR
Second Line :
City : GREENBELT
State : MD
Zip : 20770-2459
Country : US
Telephone Number : 301-741-3113
Fax Number :
Provider Business Practice Location Address
First Line : 8890 CENTRE PARK DR STE 400
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-2170
Country : US
Telephone Number : 410-884-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2021
Last Update Date : 06/10/2021

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