Provider Demographics
NPI:1790328003
Name:GIRARDI, BETHANIE ROBBINS (RN)
Entity Type:Individual
Prefix:
First Name:BETHANIE
Middle Name:ROBBINS
Last Name:GIRARDI
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 1:748 LITTLE OAK ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-7476
Mailing Address - Country:US
Mailing Address - Phone:830-325-4890
Mailing Address - Fax:
Practice Address - Street 1:748 LITTLE OAK ST
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-7476
Practice Address - Country:US
Practice Address - Phone:830-325-4890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201609679RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health