Individual
MARILENE O BEARDSLEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
2251 DUBOIS DR, WARSAW, IN 46580-3212
(574) 269-2777
Mailing address
PO BOX 1296, WARSAW, IN 46581-1296
(574) 268-9640
(574) 268-0684
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28065229A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000950A
—
IN
Enumeration date
08/23/2006
Last updated
11/16/2010
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