Provider Demographics
NPI:1770992224
Name:NEVINS, BETH (RN)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:NEVINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 W 232ND ST APT 16D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3946
Mailing Address - Country:US
Mailing Address - Phone:917-837-6091
Mailing Address - Fax:
Practice Address - Street 1:290 W 232ND ST APT 16D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3946
Practice Address - Country:US
Practice Address - Phone:917-837-6091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255786163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse