Provider Demographics
NPI:1558765701
Name:MCGARRY, BETH ANN
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANN
Last Name:MCGARRY
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 1:23299 285TH AVE
Mailing Address - Street 2:
Mailing Address - City:AKELEY
Mailing Address - State:MN
Mailing Address - Zip Code:56433-8020
Mailing Address - Country:US
Mailing Address - Phone:218-652-6702
Mailing Address - Fax:218-652-6710
Practice Address - Street 1:23299 285TH AVE
Practice Address - Street 2:
Practice Address - City:AKELEY
Practice Address - State:MN
Practice Address - Zip Code:56433-8020
Practice Address - Country:US
Practice Address - Phone:218-652-6702
Practice Address - Fax:218-652-6710
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1075464-1171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator