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General NPI Number Information
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NPI Number | 1679670202
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Entity Type | Individual
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Provider Name | BETH A DEVINE APRN
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Gender | Female
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 07/14/2015
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Provider Practice Location Address
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Address Line | 215 EAST MAIN STREET
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City | PROVIDENCE
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State | KY
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Zip | 42450-1261
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Country | US
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Telephone | 270-667-7017
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9150 REGIONAL HEALTH CARE AFFILIATES
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City | PADUCAH
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State | KY
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Zip | 42002-9150
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Country | US
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Telephone | 270-667-7017
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Fax | 270-667-9065
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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 | 4408P
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3004408
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License Number State | KY
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