Provider Demographics
NPI:1366166456
Name:BEARD, DONITA SEIBER (RN)
Entity type:Individual
Prefix:
First Name:DONITA
Middle Name:SEIBER
Last Name:BEARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2402 KNOXVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:WARTBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37887-3103
Mailing Address - Country:US
Mailing Address - Phone:865-617-4144
Mailing Address - Fax:
Practice Address - Street 1:2402 KNOXVILLE HWY
Practice Address - Street 2:
Practice Address - City:WARTBURG
Practice Address - State:TN
Practice Address - Zip Code:37887-3103
Practice Address - Country:US
Practice Address - Phone:865-617-4144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN165507163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty