Individual
MRS. BETH ALYSON BOURQUIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1 CHILDRENS PLZ, DAYTON, OH 45404-1873
(937) 641-5444
Mailing address
PO BOX 933432, CLEVELAND, OH 44193-0039
(937) 641-5072
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN.CNP.021714
OH
363LP0222X
Critical Care Pediatric Nurse Practitioner
021714
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0250859
—
OH
Enumeration date
10/25/2017
Last updated
02/17/2026
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