Provider Demographics
NPI:1457814899
Name:BRALEY, BETH ALINE
Entity Type:Individual
Prefix:
First Name:BETH ALINE
Middle Name:
Last Name:BRALEY
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 1:1325 AIRMOTIVE WAY STE 262
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3240
Mailing Address - Country:US
Mailing Address - Phone:775-828-6420
Mailing Address - Fax:
Practice Address - Street 1:1325 AIRMOTIVE WAY STE 262
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3240
Practice Address - Country:US
Practice Address - Phone:775-828-6420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No372500000XNursing Service Related ProvidersChore Provider
No376J00000XNursing Service Related ProvidersHomemaker