Provider Demographics
NPI:1336495407
Name:MONSEBROTEN, BETH ANN (CNP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:MONSEBROTEN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 HIGHWAY 71 S
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOT SPRINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57747-8801
Mailing Address - Country:US
Mailing Address - Phone:605-745-5188
Mailing Address - Fax:605-745-3039
Practice Address - Street 1:1100 HIGHWAY 71 S
Practice Address - Street 2:SUITE 101
Practice Address - City:HOT SPRINGS
Practice Address - State:SD
Practice Address - Zip Code:57747-8801
Practice Address - Country:US
Practice Address - Phone:605-745-5188
Practice Address - Fax:605-745-3039
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP000728363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily