MEDICARE: BETH HARTSOCK NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	R041286	ME
2	363LA2200X	Adult Health Nurse Practitioner	CNP81586	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265496368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH HARTSOCK NP

Provider Business Mailing Address
First Line	:	131 FRANKLIN HEALTH CMNS
Second Line	:
City	:	FARMINGTON
State	:	ME
Zip	:	04938-6142
Country	:	US
Telephone Number	:	207-778-4922
Fax Number	:	207-779-0646

Provider Business Practice Location Address
First Line	:	131 FRANKLIN HEALTH CMNS
Second Line	:
City	:	FARMINGTON
State	:	ME
Zip	:	04938-6142
Country	:	US
Telephone Number	:	207-778-4922
Fax Number	:	207-779-0646

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	02/21/2013

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Directions to “ BETH HARTSOCK NP” Practice Location

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