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General NPI Number Information
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NPI Number | 1497153720
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Entity Type | Individual
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Provider Name | BETH CORCORAN SMITH CRNP, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/19/2014
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 333 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2434
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Country | US
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Telephone | 215-214-3940
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Fax | 215-214-1425
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Provider Business Mailing Address
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Address Line | 2450 W HUNTING PARK AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19129-1302
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Country | US
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Telephone | 215-214-3940
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Fax | 215-214-1425
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP014164
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN639945
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License Number State | PA
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