Provider Demographics
NPI:1346465192
Name:EHRISMAN, BETH LYNN
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:LYNN
Last Name:EHRISMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 PAR ACRES RD
Mailing Address - Street 2:
Mailing Address - City:BEEMER
Mailing Address - State:NE
Mailing Address - Zip Code:68716-4073
Mailing Address - Country:US
Mailing Address - Phone:402-528-7266
Mailing Address - Fax:
Practice Address - Street 1:2282 E 32ND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-7233
Practice Address - Country:US
Practice Address - Phone:402-562-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8104101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health