Provider Demographics
NPI:1013265842
Name:SCHWARTZ, BETH L (CRNP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:L
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:L
Other - Last Name:GREENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:123 GRAND AVENUE, PO BOX 848
Mailing Address - Street 2:
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046
Mailing Address - Country:US
Mailing Address - Phone:724-625-3171
Mailing Address - Fax:724-625-3510
Practice Address - Street 1:123 GRAND AVENUE
Practice Address - Street 2:
Practice Address - City:MARS
Practice Address - State:PA
Practice Address - Zip Code:16046
Practice Address - Country:US
Practice Address - Phone:724-625-3171
Practice Address - Fax:724-625-3510
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012287363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103335081Medicaid