Individual provider Active NPI

Rebecca Lynn Beaubien, RN, AACNS-P

  • Pediatric Clinical Nurse Specialist
  • Fort Wayne, IN
National Provider Identifier
1174355416
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Clinical Nurse SpecialistTaxonomy code 364SP0200X
License
2000552810 Issued in IN
Practice address
Parkview Regional Medical Center
11109 Parkview Plaza Drive
Fort Wayne, IN 46845
Phone
(260) 672-6611
NPI assigned
Aug 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Clinical Nurse Specialist 364SP0200X 2000552810 IN Primary

Addresses

Primary practice location

Parkview Regional Medical Center
11109 Parkview Plaza Drive
Fort Wayne, IN 46845

Mailing address

6713 Mandarin CV
Fort Wayne, IN 46845-9158
Phone (260) 399-4899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2000552810INMDPediatric Clinical Nurse Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1174355416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6713 MANDARIN CV",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459158",
            "telephone_number": "260-399-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PARKVIEW REGIONAL MEDICAL CENTER",
            "address_2": "11109 PARKVIEW PLAZA DRIVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46845",
            "telephone_number": "260-672-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUBIEN",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "credential": "RN, AACNS-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "IN",
            "license": "2000552810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.