Provider Demographics
NPI:1245304732
Name:SANFORD, BETH ANN (ANP-C)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:SANFORD
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANN
Other - Last Name:SEIBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:213 SOUTH WHITACRE STREET
Mailing Address - Street 2:
Mailing Address - City:YERINGTON
Mailing Address - State:NV
Mailing Address - Zip Code:89447
Mailing Address - Country:US
Mailing Address - Phone:775-463-2301
Mailing Address - Fax:775-463-7864
Practice Address - Street 1:311 SURPRISE STREET
Practice Address - Street 2:
Practice Address - City:YERINGTON
Practice Address - State:NV
Practice Address - Zip Code:89447
Practice Address - Country:US
Practice Address - Phone:775-463-2301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN000639363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVAPN000639OtherSTATE OF NEVADA NURSING
NV1245304732Medicaid