Individual
MS. KIMBERLY ANN BEATTY
Active
Individual
MS. KIMBERLY ANN BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2962
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0078076700002
—
PA
01
—
050514
MEDICARE GROUP #
PA
01
—
R185390
MD LICENSE
MD
01
—
RN534747
PA LICENSE
PA
Enumeration date
11/01/2006
Last updated
03/30/2011
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