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General NPI Number Information
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NPI Number | 1467757849
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Entity Type | Individual
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Provider Name | BETH ADDICOTT CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/17/2011
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 2435 GARDEN WAY
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City | HERMITAGE
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State | PA
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Zip | 16148-5211
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Country | US
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Telephone | 724-346-6425
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Fax | 724-346-6474
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Provider Business Mailing Address
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Address Line | 2435 GARDEN WAY
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City | HERMITAGE
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State | PA
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Zip | 16148-5211
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Country | US
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Telephone | 724-346-6425
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Fax | 724-346-6474
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP010809
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License Number State | PA
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