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NPI Code Detail

MEDICARE: BETH ANNE ADDIS APN

MEDICARE: BETH ANNE ADDIS APN
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
1363LG0600XGerontology Nurse Practitioner26NJ00743700NJ

General Provider Information

NPI Number : 1952826612
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH ANNE ADDIS APN
Provider Business Mailing Address
First Line : 2106 NEW RD STE F2
Second Line :
City : LINWOOD
State : NJ
Zip : 08221-1053
Country : US
Telephone Number : 609-699-5750
Fax Number :
Provider Business Practice Location Address
First Line : 2106 NEW RD STE F2
Second Line :
City : LINWOOD
State : NJ
Zip : 08221-1053
Country : US
Telephone Number : 609-699-5750
Fax Number : 609-699-5752
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2017
Last Update Date : 06/03/2026

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