Individual
BETH ANN DEKONINCK
Active
Individual
BETH ANN DEKONINCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
71000315A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000372024
ANTHEM PROVIDER NUMBER
IN
05
—
200169950
—
IN
01
—
9397614
PHCS PID NUMBER
IN
Enumeration date
03/21/2006
Last updated
11/26/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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