=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417811449
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BETH WEISENSEE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/13/2025
-----------------------------------------------------
Last Update Date | 12/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 511 RAILROAD ST
-----------------------------------------------------
City | MORRILL
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 69358-2400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-243-0156
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 85243 E COUNTY ROAD 10
-----------------------------------------------------
City | DEER TRAIL
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80105-8920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-243-0156
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------