1922094515 NPI number — MRS. BETH ETTA MAGEE-SIEFERT MSN APN CPNP

Table of content: MRS. BETH ETTA MAGEE-SIEFERT MSN APN CPNP (NPI 1922094515)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922094515 NPI number — MRS. BETH ETTA MAGEE-SIEFERT MSN APN CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAGEE-SIEFERT
Provider First Name:
BETH
Provider Middle Name:
ETTA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSN APN CPNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MAGEE
Provider Other First Name:
BETH
Provider Other Middle Name:
ETTA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
CPNP RNC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922094515
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
124 PERSIMMON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLASSBORO
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08028-2840
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-256-9310
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
124 PERSIMMON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLASSBORO
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08028-2840
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-256-9310
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  26NN05957700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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