Provider Demographics
NPI:1366236556
Name:BESWICK, BREANNA (RN)
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:
Last Name:BESWICK
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 1:1106 MARLOWE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47129-1345
Mailing Address - Country:US
Mailing Address - Phone:812-987-6320
Mailing Address - Fax:
Practice Address - Street 1:1106 MARLOWE DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-1345
Practice Address - Country:US
Practice Address - Phone:812-987-6320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28270137C163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse