Provider Demographics
NPI:1669870481
Name:WINTERS, BETH ALLISON (APN, CNS-BC)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ALLISON
Last Name:WINTERS
Suffix:
Gender:F
Credentials:APN, CNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 VANCIL ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH FULTON
Mailing Address - State:TN
Mailing Address - Zip Code:38257-2477
Mailing Address - Country:US
Mailing Address - Phone:270-254-0176
Mailing Address - Fax:
Practice Address - Street 1:1630 E REELFOOT AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-6021
Practice Address - Country:US
Practice Address - Phone:731-885-8095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19282364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health