Provider Demographics
NPI:1780779710
Name:SCHURMAN, BETH LESLIE (MSN, RN, CS)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:LESLIE
Last Name:SCHURMAN
Suffix:
Gender:F
Credentials:MSN, RN, CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BEVERLY STREET
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103
Mailing Address - Country:US
Mailing Address - Phone:207-775-0757
Mailing Address - Fax:
Practice Address - Street 1:105 BEVERLY STREET
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103
Practice Address - Country:US
Practice Address - Phone:207-775-0757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME020022364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME010680OtherPSYCHIATRIC NURSE CLINICA
ME1036449OtherPSYCHIATRIC NURSE CLINICA
MEHARVARD PILGRIMOtherPSYCHIATRIC NURSE CLINICA
ME010680OtherPSYCHIATRIC NURSE CLINICA