Provider Demographics
NPI:1376969600
Name:BRETZ, BETH ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:BRETZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BRADDOCK ROAD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-1458
Mailing Address - Country:US
Mailing Address - Phone:724-547-4565
Mailing Address - Fax:724-547-5811
Practice Address - Street 1:1 BRADDOCK ROAD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-1458
Practice Address - Country:US
Practice Address - Phone:724-547-4565
Practice Address - Fax:724-547-5811
Is Sole Proprietor?:No
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily