MRS. BETH ALYSON BOURQUIN CNP NPI 1144732579

NPI Information

NPI: 1144732579
Provider Name: MRS. BETH ALYSON BOURQUIN, CNP
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

PECOS Registration: Yes

Address:
1 CHILDRENS PLZ
DAYTON, OH
ZIP 45404
Phone: (937) 641-5444
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MRS. Beth Alyson Bourquin, CNP is a pediatrics nurse practitioner in Dayton, OH. MRS. Beth Alyson Bourquin, CNP NPI is 1144732579. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1 CHILDRENS PLZ
DAYTON, OH
ZIP 45404-873
Phone: (937) 641-5444

The NPI 1144732579 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/25/2017 and was last updated on 2/6/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0222X	Nurse Practitioner	Pediatrics, Critical Care	021714	OHIO	No
2	363LP0200X	Nurse Practitioner	Pediatrics	APRN.CNP.021714	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0250859	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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