Provider Demographics
NPI:1396198230
Name:MCGINN, BETH (LPN)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:MCGINN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:BRUNDAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:611 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48888-9702
Mailing Address - Country:US
Mailing Address - Phone:989-831-7520
Mailing Address - Fax:989-831-7578
Practice Address - Street 1:611 N STATE ST
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:MI
Practice Address - Zip Code:48888-9702
Practice Address - Country:US
Practice Address - Phone:989-831-7520
Practice Address - Fax:989-831-7578
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703108667164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse