Provider Demographics
NPI:1700058484
Name:GUCKIN, BETH LEE (MSNA, CRNA)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:LEE
Last Name:GUCKIN
Suffix:
Gender:F
Credentials:MSNA, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 SWIFTWATER ROAD
Mailing Address - Street 2:P O BOX 2001
Mailing Address - City:WOODSVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03785-2001
Mailing Address - Country:US
Mailing Address - Phone:603-747-9000
Mailing Address - Fax:603-747-0401
Practice Address - Street 1:90 SWIFTWATER ROAD
Practice Address - Street 2:
Practice Address - City:WOODSVILLE
Practice Address - State:NH
Practice Address - Zip Code:03785-2001
Practice Address - Country:US
Practice Address - Phone:603-747-9000
Practice Address - Fax:603-747-0401
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH07100564367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered