Provider Demographics
NPI:1174921373
Name:ATKINS, BETH (LPN)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:ATKINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:ATKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:123 E GASKILL ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-1346
Mailing Address - Country:US
Mailing Address - Phone:330-277-9434
Mailing Address - Fax:
Practice Address - Street 1:123 E GASKILL ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-1346
Practice Address - Country:US
Practice Address - Phone:330-277-9434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-21
Last Update Date:2014-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.139426-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse