Provider Demographics
NPI:1891772414
Name:CAMERON, BETH LEGGETT (FNP)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:LEGGETT
Last Name:CAMERON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:DR
Other - First Name:BETH
Other - Middle Name:LEGGETT
Other - Last Name:CAMERON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP
Mailing Address - Street 1:3640 COLONEL GLENN HWY
Mailing Address - Street 2:140 UNIVERSITY HALL, COLLEGE OF NURSING
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45435-0001
Mailing Address - Country:US
Mailing Address - Phone:937-775-2665
Mailing Address - Fax:937-775-4571
Practice Address - Street 1:3640 COLONEL GLENN HWY
Practice Address - Street 2:140 UNIVERSITY HALL, COLLEGE OF NURSING
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45435-0001
Practice Address - Country:US
Practice Address - Phone:937-775-2665
Practice Address - Fax:937-775-4571
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-23
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-08387363LF0000X
IAA-084182363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily