Provider Demographics
NPI:1992964001
Name:EMERSON, BETH A (PT)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:A
Last Name:EMERSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N3985 HIGHWAY 253
Mailing Address - Street 2:
Mailing Address - City:SPOONER
Mailing Address - State:WI
Mailing Address - Zip Code:54801-8662
Mailing Address - Country:US
Mailing Address - Phone:715-468-4456
Mailing Address - Fax:
Practice Address - Street 1:N3985 HIGHWAY 253
Practice Address - Street 2:
Practice Address - City:SPOONER
Practice Address - State:WI
Practice Address - Zip Code:54801-8662
Practice Address - Country:US
Practice Address - Phone:715-468-4456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3269-024251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health