Provider Demographics
NPI:1003057084
Name:HAMSTRA, BETH RETTEW (RN, PHD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:RETTEW
Last Name:HAMSTRA
Suffix:
Gender:F
Credentials:RN, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4775 JAMESTOWN DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-2725
Mailing Address - Country:US
Mailing Address - Phone:719-502-9610
Mailing Address - Fax:719-574-3776
Practice Address - Street 1:4775 JAMESTOWN DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-2725
Practice Address - Country:US
Practice Address - Phone:719-502-9610
Practice Address - Fax:719-574-3776
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47516163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse