Individual
MS. DONNA LEE BEAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4100 W 3RD ST, DAYTON, OH 45428-9000
(937) 268-6511
Mailing address
610 WILLOWOOD DR, SPRINGBORO, OH 45066-8179
(484) 269-7027
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.362377-COA1
OH
363L00000X
Nurse Practitioner
Primary
UP006352B
PA
363LF0000X
Family Nurse Practitioner
COA.11669-NP
OH
363LF0000X
Family Nurse Practitioner
RX.11669-
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BE1834847
BLUE SHIELD
PA
01
—
P00286813
RR MEDICARE
PA
Enumeration date
10/02/2006
Last updated
03/18/2011
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