Provider Demographics
NPI:1821339995
Name:HARP, BETH
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:HARP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 ANTHONY WAYNE TRL
Mailing Address - Street 2:# 214
Mailing Address - City:WATERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43566-1509
Mailing Address - Country:US
Mailing Address - Phone:419-481-1572
Mailing Address - Fax:
Practice Address - Street 1:365 ANTHONY WAYNE TRL
Practice Address - Street 2:# 214
Practice Address - City:WATERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43566-1509
Practice Address - Country:US
Practice Address - Phone:419-481-1572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 131984164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse