Provider Demographics
NPI:1124101829
Name:ROSENSTIEL, BETH (ARNP)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:ROSENSTIEL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18870 SULFUR SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-8114
Mailing Address - Country:US
Mailing Address - Phone:360-542-4023
Mailing Address - Fax:
Practice Address - Street 1:18870 SULFUR SPRINGS RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-8114
Practice Address - Country:US
Practice Address - Phone:360-542-4023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA30003927363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily