Provider Demographics
NPI:1740202878
Name:LOPRESTI, BETH A (CRNP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:LOPRESTI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-1718
Mailing Address - Country:US
Mailing Address - Phone:856-845-0500
Mailing Address - Fax:856-384-8757
Practice Address - Street 1:127 N BROAD ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-1718
Practice Address - Country:US
Practice Address - Phone:856-845-0500
Practice Address - Fax:856-384-8757
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN511825L163W00000X
PASP008410363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA116264Medicare PIN