Provider Demographics
NPI:1023256955
Name:ROSSI, BETH ANN (PA-C)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:ROSSI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8468 HERRING RUN RD
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-5763
Mailing Address - Country:US
Mailing Address - Phone:302-629-3400
Mailing Address - Fax:302-629-5300
Practice Address - Street 1:8468 HERRING RUN RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-5763
Practice Address - Country:US
Practice Address - Phone:302-629-3400
Practice Address - Fax:302-629-5300
Is Sole Proprietor?:No
Enumeration Date:2009-01-30
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000412363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical