Provider Demographics
NPI:1720125255
Name:DIEHL SVRJCEK, BETH CAROL (CRNP)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:CAROL
Last Name:DIEHL SVRJCEK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:22 TIGREFF CT
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-1444
Mailing Address - Country:US
Mailing Address - Phone:410-663-4592
Mailing Address - Fax:410-663-4031
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:NEONATAL INTENSIVE CARE UNIT
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-5255
Practice Address - Fax:410-614-8834
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR074019363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care