Individual
TRACY L BEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
831 DILLON DR, RICHMOND, IN 47374-8048
(765) 983-8000
(765) 983-8609
Mailing address
PO BOX 487, RICHMOND, IN 47375-0487
(765) 983-8000
(765) 983-8609
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
28132815A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28132815A
RN
IN
Enumeration date
01/19/2009
Last updated
01/19/2009
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