Provider Demographics
NPI:1659180974
Name:PRIEBE, BETH (RN)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:PRIEBE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:BARTHOLOMAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:15274 OLDHAM ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-5057
Mailing Address - Country:US
Mailing Address - Phone:313-316-0847
Mailing Address - Fax:
Practice Address - Street 1:2521 N ELMS RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-9423
Practice Address - Country:US
Practice Address - Phone:810-487-5571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-01
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704364120163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics