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Individual

DAVID THOMAS BEINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGPCNP-BC

Contact information

Practice address
1716 HARTFORD ST, LAFAYETTE, IN 47904-2138
(765) 742-1567
(765) 429-2700
Mailing address
1716 HARTFORD ST, LAFAYETTE, IN 47904-2138
(765) 742-1567
(765) 429-2700

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
278-039
WI
2255A2300X
Athletic Trainer
36001848A
IN
363L00000X
Nurse Practitioner
Primary
71008226A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300030435
IN
Enumeration date
03/02/2011
Last updated
07/25/2024
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