Elizabeth A Beadles, PA-C

Individual provider Active NPI Physician Assistant · University Park, PA

NPI 1962851881 · NPPES record last updated Sep 10, 2020

Key facts

NPI
1962851881
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
OA004131 (PA)
Practice address
308 Student Health Center
University Park, PA 16802
Phone
(814) 863-6747
Fax
(814) 863-8464
NPI assigned
Jun 10, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA058374PAMDPhysician Assistant
OA004131PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Nittany Medical Center Health Services Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA058374 PA
Physician Assistant 363A00000X OA004131 PA Yes

Addresses

Primary practice location

308 Student Health Center
University Park, PA 16802

Mailing address

308 Student Health Center
University Park, PA 16802
Phone (814) 863-6747

Other names

  • Elizabeth Ann Young Former name

Other providers in University Park, PA

All providers in University Park, PA · Physician Assistant in Pennsylvania

Sources for this page

Verify at the official NPI Registry.