Provider Demographics
NPI:1750462560
Name:MCBETH, CELITA RENEE (LPN)
Entity Type:Individual
Prefix:
First Name:CELITA
Middle Name:RENEE
Last Name:MCBETH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 N GARLAND AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45403-1641
Mailing Address - Country:US
Mailing Address - Phone:937-781-9810
Mailing Address - Fax:
Practice Address - Street 1:222 N GARLAND AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45403-1641
Practice Address - Country:US
Practice Address - Phone:937-781-9810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN084174164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse