Provider Demographics
NPI:1316172828
Name:PIETRAS, BEVERLY ANN (RRT)
Entity type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:ANN
Last Name:PIETRAS
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 582
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:AZ
Mailing Address - Zip Code:85611
Mailing Address - Country:US
Mailing Address - Phone:181-449-0784
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 582
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:AZ
Practice Address - Zip Code:85611-9729
Practice Address - Country:US
Practice Address - Phone:814-490-7849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ008953227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered