Provider Demographics
NPI:1548386014
Name:FALLIN, BETH EVELYN (NP)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:EVELYN
Last Name:FALLIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF VIRGINIA HEALTH SYSTEM
Mailing Address - Street 2:BOX 800191
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-0191
Mailing Address - Country:US
Mailing Address - Phone:434-982-4456
Mailing Address - Fax:434-924-2359
Practice Address - Street 1:UNIVERSITY OF VIRGINIA HEALTH SYSTEM
Practice Address - Street 2:BOX 800191
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0191
Practice Address - Country:US
Practice Address - Phone:434-982-4456
Practice Address - Fax:434-924-2359
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166159363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care