Provider Demographics
NPI:1467757849
Name:ADDICOTT, BETH (CRNP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:ADDICOTT
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 1:2435 GARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-5211
Mailing Address - Country:US
Mailing Address - Phone:724-346-6425
Mailing Address - Fax:724-346-6474
Practice Address - Street 1:2435 GARDEN WAY
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-5211
Practice Address - Country:US
Practice Address - Phone:724-346-6425
Practice Address - Fax:724-346-6474
Is Sole Proprietor?:No
Enumeration Date:2011-01-17
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010809363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily