Individual
SUSAN ELAINE BEATY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2620 W FAIDLEY AVE, WOUND OSTOMY HEALING CENTER, GRAND ISLAND, NE 68803-4205
(308) 398-5981
Mailing address
2620 W FAIDLEY AVE, WOUND OSTOMY HEALING CENTER, GRAND ISLAND, NE 68803-4205
(308) 398-5981
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
34217
NE
363LF0000X
Family Nurse Practitioner
Primary
110221
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025288400
—
NE
05
—
47-037-6601-36
—
NE
Enumeration date
12/20/2005
Last updated
09/24/2014
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