Provider Demographics
NPI:1689930216
Name:FLUETTE, BETH M (RN)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:M
Last Name:FLUETTE
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:W2224 GENTRY DR
Mailing Address - Street 2:APT. 5
Mailing Address - City:KAUKAUNA
Mailing Address - State:WI
Mailing Address - Zip Code:54130-8510
Mailing Address - Country:US
Mailing Address - Phone:920-277-9959
Mailing Address - Fax:
Practice Address - Street 1:1981 GREENGROVE ST
Practice Address - Street 2:
Practice Address - City:KAUKAUNA
Practice Address - State:WI
Practice Address - Zip Code:54130-3921
Practice Address - Country:US
Practice Address - Phone:920-759-4436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI161108-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse