Individual ProviderJessica Susan BeatyRegistered NurseNursing Service ProvidersPractice Address4212 N 16th St, Phoenix, AZ 85016-5319(602) 263-1511PECOS EnrollmentBased on the most recent information from CMS, provider Jessica Susan Beaty does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1194885616Provider TypeIndividualFull NameBeaty, Jessica SusanCredentialRNGenderFemaleSole ProprietorNoEnumeration Date12/12/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address4212 N 16th St, Phoenix, AZ 85016-5319Phone(602) 263-1511Fax(602) 263-1619Mailing LocationMailing AddressPO Box 31001-0698, Pasadena, CA 91110-0698Phone(602) 263-1511Fax(602) 263-1619Provider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicenseRN133065Arizona