MEDICARE: BETH LYNN EHRISMAN

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
1	101YM0800X	Mental Health Counselor	8104	NE

General Provider Information

NPI Number	:	1346465192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH LYNN EHRISMAN

Provider Business Mailing Address
First Line	:	110 PAR ACRES RD
Second Line	:
City	:	BEEMER
State	:	NE
Zip	:	68716-4073
Country	:	US
Telephone Number	:	402-528-7266
Fax Number	:

Provider Business Practice Location Address
First Line	:	2282 E 32ND AVE
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68601-7233
Country	:	US
Telephone Number	:	402-562-7500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/08/2007

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Directions to “ BETH LYNN EHRISMAN ” Practice Location

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