Provider Demographics
NPI:1598978702
Name:PEARSON, S. BETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:S.
Middle Name:BETH
Last Name:PEARSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3140 N 113TH LN
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-4212
Mailing Address - Country:US
Mailing Address - Phone:623-877-2799
Mailing Address - Fax:
Practice Address - Street 1:4940 N 103RD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-5022
Practice Address - Country:US
Practice Address - Phone:623-772-2490
Practice Address - Fax:623-877-8977
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN057570163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse