Provider Demographics
NPI:1316507205
Name:HORSEMAN, BETH (FNP)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:HORSEMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:DARGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2024 SHAWNEE ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-1683
Mailing Address - Country:US
Mailing Address - Phone:913-683-8445
Mailing Address - Fax:
Practice Address - Street 1:2024 SHAWNEE ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-1683
Practice Address - Country:US
Practice Address - Phone:913-683-8445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS78863363LF0000X, 363L00000X
KSF06190102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily