Provider Demographics
NPI:1831970276
Name:PICKUP, BETH LAUREL (RN)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:LAUREL
Last Name:PICKUP
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 1:217 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:SELKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:12158-1713
Mailing Address - Country:US
Mailing Address - Phone:518-391-3279
Mailing Address - Fax:
Practice Address - Street 1:260 S PEARL ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12202-1809
Practice Address - Country:US
Practice Address - Phone:518-447-5909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY718816163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse