Provider Demographics
NPI:1639364599
Name:LEE, BETH EDNA (ANP)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:EDNA
Last Name:LEE
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:LEE
Other - Last Name:SLINGLUFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:3800 W CAMINO NUESTRO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-9755
Mailing Address - Country:US
Mailing Address - Phone:520-873-3844
Mailing Address - Fax:520-873-5014
Practice Address - Street 1:3800 W CAMINO NUESTRO
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-9755
Practice Address - Country:US
Practice Address - Phone:520-873-3844
Practice Address - Fax:520-873-5014
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZANP093363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health