MEDICARE: BETH B VANAIRSDALE APRN,FNP-C

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	363LF0000X	Family Nurse Practitioner	71002321A	IN
2	363LF0000X	Family Nurse Practitioner	0033746	OH
3	363LF0000X	Family Nurse Practitioner	AP30007297	WA
4	363LF0000X	Family Nurse Practitioner	1084532	TX
5	363LF0000X	Family Nurse Practitioner	APN.0991675	CO
6	363LF0000X	Family Nurse Practitioner	NP-738A	ID
7	363LF0000X	Family Nurse Practitioner	10025884	OR
8	363LF0000X	Family Nurse Practitioner	2024046748	MO
9	363LF0000X	Family Nurse Practitioner	231512	AR
10	363LF0000X	Family Nurse Practitioner	308243	AZ
11	363LF0000X	Family Nurse Practitioner	209032426	IL
12	363LF0000X	Family Nurse Practitioner	3005274	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932277514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH B VANAIRSDALE APRN,FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 211699
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55121-3699
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:	888-973-8821

Provider Business Practice Location Address
First Line	:	8354 E NORTHFIELD BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80238-3131
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:	888-973-8821

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

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	07/09/2025

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