Provider Demographics
NPI:1811559834
Name:GARRISON, BETH ANNE (FNP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANNE
Last Name:GARRISON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANNE
Other - Last Name:PLUMADORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:214 CORNELIA ST STE 203
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-2332
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:214 CORNELIA ST STE 203
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2332
Practice Address - Country:US
Practice Address - Phone:518-563-2404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-29
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344653363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily