Provider Demographics
NPI:1912251539
Name:CONNELLY, BETH ABIGAIL MEAUX (BSN, RN, NNP-BC)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ABIGAIL MEAUX
Last Name:CONNELLY
Suffix:
Gender:F
Credentials:BSN, RN, NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:1132 FARMERS BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:27592-8970
Mailing Address - Country:US
Mailing Address - Phone:919-559-4556
Mailing Address - Fax:
Practice Address - Street 1:DUKE NEONATOLOGY DUMC 2739
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-8970
Practice Address - Country:US
Practice Address - Phone:919-970-3707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005919363LN0000X, 363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal