Provider Demographics
NPI:1528280138
Name:KAPPES, BETH ANNE (MSPT)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ANNE
Last Name:KAPPES
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 N PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-2647
Mailing Address - Country:US
Mailing Address - Phone:208-985-3738
Mailing Address - Fax:208-473-2211
Practice Address - Street 1:521 N PACIFIC ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-2647
Practice Address - Country:US
Practice Address - Phone:208-985-3738
Practice Address - Fax:208-473-2211
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID4087225100000X, 2251P0200X
MI55010096082251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics