Provider Demographics
NPI:1679005185
Name:BOTTI, BETH ANN (RN)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:BOTTI
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 1:2 THEODORE DRIVE EXT
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-3702
Mailing Address - Country:US
Mailing Address - Phone:412-691-2033
Mailing Address - Fax:
Practice Address - Street 1:2 THEODORE DRIVE EXT
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-3702
Practice Address - Country:US
Practice Address - Phone:412-691-2033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN513746L163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health